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MATERIA MEDICI 



AND 



THERAPEUTICS. 



MATERIA MEDICA 



THERAPEUTICS: 



AMPLE ILLUSTRATIONS OF PRACTICE 



IN ALL THE 



DEPARTMENTS OF MEDICAL SCIENCE, 



AND VERY 



COPIOUS NOTES OF TOXICOLOGY, 



SUITED TO THE WANTS OF MEDICAL STUDENTS, PRACTITIONERS; AND TEACHERS. 



A NEW EDITION, REVISED AND ENLARGED. 



BY 

THOMAS D. MITCHELL, A.M., M.D., 

Professor of Materia Medica and General Therapeutics in Jefferson Medical 
College, and formerly Professor of Chemistry, Materia Medica, and 
Theory and Practice in the Medical College of Oh'io, Transyl- 
vania University, and the Kentucky School of Medicine ; 
Author of "Elements of Chemical Philosophy," &c. &c. 



PHILADELPHIA : 

J. B. LIPPXNCOTT AND C 

22 and 24 NORTH FOURTH STREET. 

1857. 




c\> 



1? 



Entered according to the Act of Congress, in the year 1857, by 

THOMAS D. MITCHELL, 

in the Clerk's Office of the District Court for the Eastern District of Pennsylvania. 



TO THE 



HUbifsI Inrfissiffit 



UNITED STATES OE AMERICA, 



ESPECIALLY TO HIS FORMER PUPILS IN THE SOUTH AND WEST, 



THIS VOLUME 



VERY RESPECTFULLY DEDICATED 



THE AUTHOR. 



PREFACE TO THE NEW EDITION 



It is said that nobody reads a Preface, and whether 
this be read or not is immaterial. It is written chiefly 
to say that the author has carefully revised the work, 
and brought it down fully to the present time. As a 
consequence, the bulk of the volume is augmented, a cir- 
cumstance altogether unavoidable. He has added his 
own experience on various points, and the best testimony 
of the great world of physic, with the design of putting 
a book of real value into the hands of students and prac- 
titioners. Theoretical notions, which are but too often of 
mushroom stability, have been almost entirely eschewed, 
and the book is therefore chiefly a volume of facts, quite 
as reliable as any to be furnished by the profession any- 
where. He gives it to the public, not as a perfect pro- 
duction, but as an humble contribution to the medical 
literature of the United States. Designed as a book of 
reference for teachers and practitioners, it will be found 
to contain a vast amount of facts which cannot be found 
in any other volume. To the student who listens to a 
course on Materia Medica under any of the methods of 
classification, it will prove a useful help, as all the articles 
ordinarily brought to notice are presented in detail. 

It is believed that every valuable new application of 
an old reinedv, as well as the desirable uses of agents 



8 PREFACE. 

claimed to be new, down to the date of this prefatory 
note, are here presented so as to set forth their real or 
apparent worth. 

The careful reader may detect a few errata, but they 
are so unimportant that it was not deemed necessary to 
point them out in a separate notice. 

We have taken more than ordinary pains with our 
Index and Table of Contents, so as to aid the reader in 
what we regard a matter of importance. Since this edi- 
tion has been passing through the press, we have more 
than once sought for articles in the index of the most 
elaborate treatise on Materia Medica now extant, without 
being able to find the object of our research at all. In 
truth, a book with a defective or erroneous index loses 
half its value, in our estimation. 

Philadelphia, October 1, 1857. 



CONTENTS AND INDEX. 



Abies excelsa, 51 

Absynthium, 52 

Acacia catechu, 283, 284 

vera, 52-54 
Acetate of lead, 662 
Acetic acid, 56 

therapeutical properties of, 56 
Acetum, 55 

medicinal uses of, 55, 56 
poison of, 58, 59 
Acid, benzoic^ 59 

how obtained, 59 

medicinal uses of, 61 

poison of, 61 
citric, 61 

how made, 62 

medicinal uses of, 61, 62 

poison of, 63 
gallic. (See Galls.) 
hydrocyanic, 64 

how made, 64 

poison of, 66-70 

properties of, 64 

tests of, 70 

uses of, 66-69 
hydrochloric, 70 

medicinal uses of, 71, 72 

poison of, 73 

properties of, 70 
nitric, 73 

how made, 73 

poison of, 84-86 

properties of, 73-84 
nitro-hydrochloric, 82, 83 

use as a bath, 83 
oxalic, mistaken for Epsom salt, 

575 
Prussic, 64 
pyroligneous, 56 

medicinal uses of, 57 
sulphuric, 86 

antidotes for, 90 

found in the blood, 89, 90 

how detected, 90 

how made, 86 

medicinal uses of, 87-89 

poison of, 89 



Acid, tannic, 91 

how made, 91 
medicinal uses of, 91, 92 

tartaric, 93 
uses of, 93 
poison of, 93 
Aconite, 93-99 
Aconitina, 94 
Aconitum napellus, 93-99 

poison of, 94-98 

preparations of, 94-98 

therapeutical uses of, 94 

uses of, 94-96 
Acupuncture, 99 

medicinal uses of, 100 

modus operandi, 100 
Adeps suilhe, 100 

uses of, 101 
Adulteration of medicines, 101, 102 
Aerated magnesian water, 574 
iEthiop's mineral, 519 
Agriculture, 102, 103 
Alcohol, 103 

absolute, 104 

effects of, 107-111 

external use safest, 105 

found in the brain, 112 

fortius, 104 

its nature, 103 

not needful in health, 104 

poison of, 107 

wholly artificial, 103 
Alcoholic liquors adulterated, 103 
Alimentaria materia, 113 
Allium sativum, 114, 115 
Allopathy, 115 
Almonds, 140 
Aloes, 115 

doses of, 119 

elements of, 116 

endermic use of, 119 

how emmenagogue, 118 

improved by mixture, 118, 119 

relation to piles, 117 

therapeutical qualities, 116-118 

varieties of, 115, 116 

whence obtained, 115 

ix 



CONTENTS AND INDEX. 



Alphabetical arrangement, 26 

why preferred, 26 
Alterative, 119 
Alum, 120 

a poison, 124 

burnt, 124 

curd and whey, 123 

how obtained, 120 

incompatibles, 120 

medicinal uses of, 120-124 

varieties of, 120 
Alumen ustum, 124 
Ammonia, 124 

acetate of, 135 

alcohol of, 124 

aromatic spirit of, 129 

carbonate of, 132, 133 

fetid spirit of, 130 

hydrochlorate of, 130 . 

hydrosulphuret of, 1.39 

liquid, 124 

medicinal uses of, 125-139 

muriate of, 130 

phosphate of, 138 

spirit of, 124 

valerianate, 139 

water of, 124 
Ammoniacal beer, 132 
Ammoniac gum, 140 
Ammoniated alcohol, 124 

tincture of opium, 618 
Amorphous quinine, 710 
Amygdalae, 140 
Amylene, how made, 140 

uses of, 141 
Amylum, 141 
Anaesthetic, 146 
Angustura bark, 412 
Animal food, 141 

sometimes poisonous. 143-146 
Animal magnetism, 437 
Anodyne, 146 
Antacids, 146 
Antagonism of poison and disease, 141 

149 
Anthelmintics, 56, 69, 72, 149, 158 
Anthemis nobilis, 153 

pyrethrum, 644 
Anti-convulsive, 269 
Antidotes, 153 
Anti-inflammatory, 1 53-156 
Antimonial, 154 

preparations, 154-162 
Antimonium, 154 
Antimony, 154 

calx of, 155 

chloride of, 165 

crude, 154 

everlasting pill of, 154 

glass of, 155 

golden sulphuret of, 155 



Antimony, metallic, 154 

potassio tartrate of, 155 

regulus of, 154 

sulphuret of, 154 

tartarized, 155 

wine of, 158 
Antiperiodic, 165 
Antiphlogistic, 166 
Anaplastic, 166 
Apiol, 166 
Aqua, 166 

ammonia, 124 

fort is, (See Nitric acid.) 

medicinal uses of, 168-176 

phagedenica, 499, 510 

very old remedy, 168 
Arctium lappa, 176 
Argentum, 177 

uses of its preparations, 177-189 
Armenian bole, 190 
Arnica montanum, 190 
Aromatic spirit of ammonia, 129 
Arrow-root, 581 
Arsenic, 190 

acids of, 190-192 

antidotes, 201-203 

detection of, 204-207 

effects on birds, &c, 191, 192 

Fowler's solution, 193-196 

modus operandi, 197 

pills of, 194 

poison of, 199, 200 

remedial use of, 193-197 

statistics, 194 
Artemisia santonica, 208 
Asparagus, 208 
Aspidium filix mas, 208 
Assafcetida, 209 

milk of, 210, 211 

properties and uses, 210-212 

Asthmatic elixir, 618 

Astringents, 212-214 

Atropa belladonna, ") ,„ 7 > 77 7 \ 

., • *. ' y (See Belladonna.) 

Atropia, J v 

Aurum, 214 

preparations and uses, 214-216 

Auscultation, 216, 217 

Avenae farina, 217 

Baccae juniperi. (See Juniper Berries. ) 
Balsam, 217 

copaiba, 383 

Friar's, 218 

Hill's, 219 

Tolu, 218 

Turlington's, 219 
Bark beer, 300 
Bark, angustura, 412, 413 

jacket, 300 



CONTENTS AND INDEX. 



XI 



Bark, poultice, 300 

uses of, 299-301 
Basilicon ointment, 711 
Bathing, 219-231 
Baths, 219 

Battley's sedative liquor of opium, 617 
Bebeerine, 231 

sulphate of, 231 

substitute for sulph. quinine, 231 
Beef essence, 232 

tea, 232 
Belladonna, 232 

action on eye and skin, 234, 235 

antidote for, 234 

doses, 233-236 

external uses, 237, 238 

inhalations of, 237 

poisonous, 233, 234 

prophylactic, 234-236 

proximate principle of, 238 
Belleville's cerate, 507 
Benne plant, uses of, 239 
Benzoic acid, 59 
Benzoin, water of, 60 
Bermuda arrow-root, 581 
Bi-cyanide of mercury, 519 
Bignonia ophthalmica, 239 
Biniodide of mercury, 521 
Bismuth, 239 

large doses of, 240 

poison of, 241 

tris-nitrate, 239 

uses of, 240, 241 

white oxide, 239 
Bittera febrifuga, -241 
Bitter apple. (See Colocynth.) 376 
Bitterine, 241 

Blackberry. (See Rubus Trwialis.) 
Black drop, 616 
Black hellebore, 805 
Black lint, 241 
Black wash, 510 
Blistering point, 273 
Bloodletting, 242 

in Asiatic cholera, 244-247 

rules for, 242 
Blood root. (See Sanguinaria,) 
Blue alum, 412 
Blue copperas, 409 
Blue mass, 494, 495 

easy mode of making, 494 

ointment, how made, 494 
Blue stone, 411 
Blue vitriol, 409 
Bolus ad quart anum, 105 
Boneset. (See Eupatorium Perfoliatum. ) 
Borax, 751 

Brandy, seldom pure, 113 
Bread pills, 248, 249 
Bromine, 249 

medicinal uses of. 249, 250 



Brucia, 250 
Brucine, 250 
Buchu, 250 

medicinal uses of, 250, 251 
Burdock root, its uses, 177 
Burgundy pitch plaster, 51, 52 
Burns and scalds treated with 

adhesive plaster, 660 

alcohol, 106 

castor oil, 721 

chlor. lime, 259 

chlor. soda, 756 

collodion, 374 

cotton, 386 

creosote, 390 

elder ointment, 728 

flour, 455 

gum Arabic, 54 

iced water, 174 

iodine, 535 

Kentish ointment, 793 

lime liniment, 254 

muriate of soda, 757 

nitrate of silver, 181 

slippery elm, 802 

soap, 685 

tar, 659 

vinegar, 56 

whisky, 106 

white paint, 661 
Burnt alum, 134 

uses of, 124 
Burnt sponge, 761 

Cajeput oil, 251 

use in cholera, 251, 252 
Calcined magnesia, 571 
Calcis aqua, 253 
Calcium, oxide of, 253 
Calomel, 498 

earliest antiphlogistic use, 499 

early use in yellow fever, 500 

fractional doses, 503 

Howard's, 499 

how obtained, 498 

how purified, 499 

hydro-sublimed, 499 

medicinal uses, 506 

modes of giving, 506 

ointments of, 506, 507 

origin of the term, 499 

poison of, 508-510 

reparatory action of, 500 

tests of, 498 

use in Asiatic cholera, 501 
Calumbo, 252, 253 
Calx, 253 

properties of, 253, 254 
Cambogia, 261 

uses of, 262 
Camphor, 263 



Xll 



CONTENTS AND INDEX. 



Camphor, crude and refined, 263 

julep and mixtures, 265-267 

medicinal uses of, 264-268 

oil of, 263 

poison of, 268 

spirit of, 264 

therapeutic properties of, 264 
Camphorated citrine ointment, 517 

tincture of opium, 618 
Cannabis indica, 269 

uses of, 269, 270 
Cantharidal collodion, 376 
Cantharides, 270 

how obtained, 270 

modes of using, 271-275 

plaster and ointment, 272 

poison of, 278 

varieties of, 270 

why they fail to vesicate, 273 
Cantharidin, 271 
Capsicum annuum, 279 

adulterations and uses, 279, 280 
Capsules, 280 
Carbo ligni, 281 
Carrageen, 282 
Castor oil, 718 
Catechu, 283 

properties and uses, 284 
Cathartics, how they act, 284 

right use of, 285 

varieties of, 284-286 
Caustic, common, 286 

lunar, 286 
Cayenne pepper, 279 

properties and uses, 279, 280 
Cautery, actual and potential, 286 
Cedron, 28? 
Cerusse, 661 
Chalk julep, 255 
Chalybeate bread, 469 
Charcoal, 281 
Cheese, 287 

poisonous, 288 
Chelsea pensioner, 777 
Chenopodium anthelminticum, 289 
Chilblains, treated with 

acid, hydrochloric, 71 

cayenne pepper, 279 

chlorides, 259 

collodion, 376 

copaiba, 384 

creosote, 389 

iodine, 535 

lunar caustic, 179 

muriate of lime, 261 

sugar of lead, 663 

turpentine, 793 
China Bogotensis, 289 
Chloride of lime, 255 

disinfectant, 25£, 256 

how made, 255 



Chloride of lime, medicinal uses of, 

257-259 
Chlorine, antidotal, 290 
Chlorine, properties and uses, 289-292 

water, 291 
Chloroform, 292-296 
Cholagogues, 296 
Cholera, Asiatic, treated with 

blood letting, 244-247 

cajeput oil, 251 

calomel, 500, 501 

camphor, 265 

carbonate of soda, 748 

chlorine, 291 

chloroform, 293 

creosote, 392 

croton oil, 396 

essence of ginger. 819 

ethers, 449 

flannel, 475 

gallic acid, 476 

ice, 170 

mustard, 746 

nitrate of silver, 187 

nitric acid, 75 

opium, 618, 628 

oxygen gas, 640 

persequinit. of iron, 466 

phosphorus, 649 

sugar of lead, 664 

sulphur, 777 

sumbul, 782 

tannin, 91 

tobacco, 607 
Cholera, infantum, treated with 

argent, nit. 187 

bark bath, 301 

bark jacket, 300 

calomel, 502, 503 

eoffee, 363 

flannel, 475 

geranium, 479 

hyd. cum creta, 496 

monesia, 596 

oak bark, 710 

sanguinaria, 730 

sugar of lead, 664 
Cholera worm, 251 
Chondrus crispus, 296 
Chorea, treated with 

chloroform, 293 

cimicifuga, 297 

copper salts, 409 

elaterium, 432 

emetics, 164 

iron, 458 

oxide of zinc, 811 

sugar of lead, 665 

sulphuret of potash, 781 

strychnia, 769 
Cimicifuga racemosa, 296 



CONTENTS AND INDEX. 



Xlll 



Cimicifuga racemosa, medicinal uses 

of, 297, 298 
Cinchona, 298 

extract of, 300 

origin of the term, 298 

salts of, 302-326 

uses of, 300, 301 

varieties of, 299 

woods, 298 
Cinchonine, 301, 302 
Cinchonism, 327 
Cinnamon, 327 
Cissampelos pareira, 642 
Citrate of magnesia, 576 
Citric acid, 61 
Citrin ointment, 517 
Cleavers. (See Galium.) 
Climate, influence on medicinal action, 
328-341 

as a therapeutic agent, 328-341 
Clysters, 341 

formulae for, 344 

various kinds, 343 
Cocoanut palm, 345 
Cocos nucifera, 345 
Cocculus indicus, 345 

medicinal uses of, 347 

poison of, 346 
Cochlearia armoracia, 347 

compound spirit of, 348 

properties of, 347 

uses of, 347 
Codeine, 613 
Cod-liver oil, 348 

analysis of, 349 

augments weight of body, 354 

substitutes for, 348 

tests of, 362 

uses of, 350-360 

varieties of, 349 
Coffee, anti-emetic, 363 

antidote, 362, 363 

how it acts, 362 

in asthma, 363 

in hooping-cough, 364 

in cholera infantum, 363 

in intermittents, 363 
Colchicum autumnale, 365-372 
Cold water practice, 167-173 
Collodion, 373 

cantharidal, 376 

caustic, 376 

ferruginous, 376 

uses of, 373-375 
Colocynth, 376 

compound extract of, 377 

oil of, 377 

poisonous, 377 
Colocynthine, 376 
Columbo, 252 
Compound poisoning, 377-381 



Confectionery poisoned, 401 
Confidence, influence of on remedies, 45 
Coneia, 382 
Conium maculatum, 381 

extract of, 381 

uses of, 382 
Contra stimulant, 382 
Copaiba, 383 

induces a peculiar eruption, 384 

properties and uses, 383, 384 

solidified, 384 
Copalchi bark, 385 
Copper, 400 

acetate of, 401-409 

ammoniuret of, 409 

metallic not poisonous, 400 

oxide of, 400 

poisonous salts of, 401-409 

sulphate of, 409 
Copperas, 461 
Coptis trifoliata, 385 
Coriandrum sativum, 385 
Cornus, 385 
Corrosive sublimate, 386, 510, 511 

antidotes for, 515 

doses of, 511 

eater of, 513 

enters panaceas, 511 

external uses of, 512 

how made, 510 

medicinal uses, 511, 512 

poison of, 513-515 

sensible qualities, 510 

solubility of, 510 

tests of, 516 
Cotton, medicinal uses of, 386, 387 
Cotyledon umbilicus, 387 
Counter-irritant, 387 

poison, 388 
Cowhage, 388 

Crab's claws. (See Calx.) 388 
Cranberry. (See Vaccinium.) 
Creosote, 388 

anti-emetic, 391, 392 

inhalations of, 393 

poisonous, 388-394 

properties of, 388, 389 

uses of, 389 
Cremor tartar, 691, 692 
Creta preparata, 254 
Croton oil, 394 

adulteration of, 394-399 

medicinal uses of, 395-398 

poisonous, 398, 399 
Croup, treated with 

alum, 123 

antimonial wine, 159-163 

argent, nit. 179 

assafsetida, 212 

copper, sulphate of, 410 

squill, 735 



XIV 



CONTENTS AND INDEX. 



Croup, treated with 

turpentine, 791 

turpith mineral, 516 
Crusta lactea, 496 
Cubebs, 399 

medicinal uses of, 399, 400 

oil of, 399, 400 

powder of, 399 

sensible qualities, 399 
Cupping, dry, 487 
Cuprum. (See Copper.) 400 
Cuspariae cortex, 412 
Custom, influence of on remedies, 43 

Dalby's carminative, 573 
Daphne mezereon, 413 
Datura stramonium, 413 

doses of, 415 

extract of, 415 

medicinal uses, 415, 416 

poisonous, 413, 414 

sensible qualities, 413 
Daturia, 413 
Decoctions, 416 

formula* for, 416, 417 
Depuration, 417-420 
Deutiodide of mercury, 521 
Dewberry. (See Rubus.) 
Diaphoretic, 420 

Diarrhsea and cholera-mixture of Sur- 
geon Sharp, U.S.N., 266 
Diarrhsea, treated with 

alum, 121 

argent, nit. 188 

blisters, 275 

blue vitriol, 410 

calumbo, 252 

castor-oil, 721 

catechu, 283 

cimicifuga, 297 

coffee, 364 

creosote, 392 

creta ppt., 255 

hydrarg. cum creta, 496 

ipecacuanha, 549 

kino, 552 

nit. argenti, 188 

persesquinit. iron, 466 

phosphorus, 649 

rhatany, 712 

strychnia, 772 

sulph. iron, 461 

sulph. acid, 88 

sulph. quinine, 321 

syr. rhei, 718 

tannic acid, 91 
Diet, 420-422 
Digitalis purpurea, 423 

cumulative, 424 

external uses of, 427 

influenced by climate, 423 



Digitalis purpurea, poisonous, 424 

therapeutic properties of, 424 

variable doses of, 423 
Digitalism, 424 
Digitaline, 427 

Diluted sulphuric acid, 87-89 
Dinner pill, 716 
Diosma crenata, 428 
Diospyros Virginiana, 428 
Discoloration of skin by lunar caustic, 

185 
Discutients, 429 
Disinfectants, 429 
Displacement, 429 
Distilled vinegar, 56 
Diuretics, 429 
Dock root, 724 
Dog-liver oil, 348 
Dolichos pruriens, 430 
Donovan's mercurial liquid solution, 521 
Dover's powder, original, 548 
Drake's tinct. digitalis, 425 
Drimys Winteri, 430 
Dropsical effusion treated with sulph, 

quinine, 321 
Dry cupping, 487 
Dutch liquid, 430 
Dysentery, treated with 

blisters, 275 

castor-oil, 721 

chlorides, 260 

clysters, 343 

Epsom salt, 576 

guiacum, 484 

gum Arabic, 54 

ipecacuanha, 544 

Irish moss, 282 

lemon-juice, 559 

opiates, 619 

pomegranate, 707 

rhatany, 712 

slippery elm, 802 

strychnia, 772 

sugar of lead, 664 

tartar emetic, 162 

tobacco, 606 

vinegar, 55 

Eau medicinale d'Husson, 373 
Ectrotic medication, 430 
Effervescing mixtures, 686, 750 
Elaterium, 431 
Elatin, 433 
Elder, 728 
Electricity, 433-438 

animal, 434 

common, 436 

galvanic, 437 

magnetic, 437 

mesmeric, 438 
Electro-puncture, 100 



CONTENTS AND INDEX. 



XV 



Elimination, 438 

Elixir of vitriol, 87 

Elm, slippery, 802 

Emetic, tartar, 439 

Emetics, 439-443 

Emetin, 443, 550 

Emeto-catliartic, 443 

Emmenagogues, 443 

Emulsions, 444 

Eudermic medication, 444, 445 

Enemata, 445 

Epilepsy, treated with 

acetate of lead, 665 

cotyledon, 387 

extraction of teeth, 453 

indigo, 528 

lunar caustic, 185 

monkshood, 94 

moxa, 597 

trephining, 799, 800 
Epispastics, 445 
Epsom salt, 574 

acidulated mixture of, 576 

bitterness obviated, 575 

doses, 575, 576 

how known from oxalic acid, 575 

how obtained, 574 

uses, 575, 576 
Epulotic cerate, 811 
Ergot, 445, 735 

of rye, frauds in, 738 

how long it may be kept, 737 

medicinal uses, 740, 741 

nature of, 735, 736 

obstetrical relations, 736 

poisonous, 738 

preparations of, 738, 739 

uva ursi a substitute, 740 

wheat, 740 
Erigeron Philadelphicum, 732 
Errhines, 445 
Erysipelas, treated with 

blisters, 276 

collodion, 375 

cotton, 386 

creosote, 390 

hemlock, 382 

iodine, 534 

lard, 101 

nitrate of silver, 180 

Prussic acid, 68 

sulph. iron, 462 

warm water, 175 
Ethers, 446-451 
Ethereal inhalation, 448 
Ethiop's mineral, 451 
Eupatorium perfoliatum, 451 

modes of using, 451 

use in ague, 451 
Exercise, 452 
Expectorants, 452 



External use of calomel, 506 
Extraction of teeth, 453 
Extract of henbane, 523 
Extracts, 454 

Farina, 454, 455 

Fell's treatment of cancer, 817 

Fennel, 456 

Ferrum, 456 

Fetid spirit of ammonia, 130 

Figgy senna, 744 

Firing, 470 

Fish, poisonous, 472, 473 

Fissure of nipples, treated with 

acid, pyroligneous, 57 

argent, nit rat., 181 

catechu, 283 

collodion, 375 

tannin, 92 
of the rectum, treated with 

acid, tannic, 92 

argent, nitrat., 183 

rhatany, 713 
Fixed alkali, 681 
Flannel, uses and abuses of, 474 
Flaxseed tea and poultice, 564 
Flies, American, 270 

Spanish, 270 
Flowers of benzoin, 59 

of zinc, 810 
Foxglove, 423 
Freckle wash, 562 
Friar's balsam, 218 

Galium aparine, 475 

Gallse, 475 

Gallic acid, 476 

Galls, 475 

Galvanic electricity, 435 

Galvano-puncture, 100 

Gamboge, 261 

medicinal uses of, 262 
Gargles, formula for, 477 
Garlic, 114, 115 
Gentian, 478 

Geranium maculatum, 479 
Ginger, preparations of, 819 

beer, 819 
Glauber's salt, 753 

effects on the blood, 753 
Glycerine, 480-483 

endermic use of, 483 

how obtained, 480 

medicinal uses of, 481, 482 

nutrient properties, 482 

pharmaceutical uses, 481 

substitute for cod-liver oil, 348 

what it is, 480 
Gold, preparations of, 214, 215 
Golden thread. (See Coptis.) 385 

medicinal and surgical uses of, 385 



XVI 



CONTENTS AND INDEX. 



Gossypium herbaceum, 483 
Green hellebore, 805 
Goulard's extract, 660 
Gowland's lotion, 512 
Granville's lotion, 126 
Griffith's tonic mixture, 457 
Grocer's alum. (See Potash.) 483 
Gruel, 483 
Guiacum, 483 

medicinal uses of, 484 
Gum Arabic, 52 

mucilage of, 54 

properties of, 54 

uses of, 54 

varieties, 53 
Gunpowder and its medicinal uses, 484 
Gutta percha, 485, 486 

Habit controls medicinal action, 43 
Hsematoxylon campeachianum, 486 
Hsemospastics, 486, 487 
Haemostatics, 487 
Hahnemanic philosophy, 47, 48 
Hamamelis Virginiana, 488, 489 
Headland's classification, 27 
Hellebore, 488 
Helonias diceca, 488 
Hemlock, 381 
Hemp, Indian, 269 
Hepar sulphuris, 780 
Hiera pi era, 119 
Hill's balsam of honey, 219 
Hoffman's anodyne, 449 
Hog's lard, 100 
Holly, 526, 527 

Homoeopathy. (See Infinitesimal Prac- 
tice. ) 
Honey, poisonous, 586 

uses of, 586 
Hooping-cough, treated with 

belladonna, 236 

cantharides, 276 

carb. ferri, 458 

coffee, 364 

hydrocyanic acid, 67 

musk, 597 

narcissus, 601 

nitrate of silver, 180 

nitric acid, 82 

sulph. zinc, 812 

sulphuric ether, 447 
Horse-radish, 347 
House leek, 387 
Howard's calomel, 499 
Humulus lupulus, 489, 490 
Huxham's tincture, 300 
Hydrargyrum. (See Mercury.) 490 

cum creta, 496 
Hydriodate of potash, 537-541 
Hydropathy, 523 
Hydro-sublimed calomel, 499 



Hyosciamin, 525 
Hyosciamus, 523 
Hypnotic, 525 

Ice, medicinal uses of, 170 
Ictodes fetida, 520 

properties of, 520 
Idiosyncrasy, 42 
Hex, 526, 527 
Hicene, 527 
Indian hemp, 269 
Indigo, 528 
Introduction, 25-50 
Infinitesimal doses, 528-530 

do they salivate? 509 
Infusions, 530, 531 

formulae for, 531 
Inhalations, 532 
Injections, 532 
Intestinal worms, 152 
Introductory remarks, 26-50 
Iodide of arsenic, 543 

lead, 665 

mercury, 520, 521 

potassium, 537-541, 544 

quinine, 543 

starch, 542 

sulphur, 543 

zinc, 817 
Iodine, 532 

action of, 533 

adulterations of, 533 

emmenagogue, 536 

how obtained, 532 

inhalations of, 542 

injections of, 535, 536 

ointment of, 537 

preparations of, 533-537 

tincture of, 533, 534 

tests of, 533 

uses of, 533-515 
Iodized oil, 543 
Iodism, 543 
Iodognosis, 544 
Iodo-hydrarg. pot., 521 
Ioduretted solution, 541 
Ipecacuanha, 544 

adulteration of, 545 

earliest use of, 548 

liniment, 549 

peculiar effects, 545 

tea, 546 

uses of, 544-549 

wine of, 547 
Irish moss, 282 
Iron, action on the blood, 469 

bread of, 469 

carbonate of, 456 

citrate of, 464 

clinkers of, 456 

ferrocyanate of, 463 



CONTENTS AND INDEX. 



XV11 



Iron, filings, 456 

glycerine solutions of, 470 
iodide of, 466 
lactate of, 468 
muriated tincture of, 459 
persesqui nitrate of, 465 
pills of Blaud, 461 
phosphates of, 462 
powder of Bouchardat, 456 
prussiate of, 463 
rust of, 456 

syrup of carbonate of, 458 
sulphate of, 461 
tannate of, 469 
tartrate of potash and, 463 

Jalap, 525, 526 
James's fever powder, 164 
Jamestown weed, 453 
Jesuit's drops, 385 
Juglans cathartica, 550 

uses of, 551 
Julep of camphor, 265 

chalk, 255 

volatile alkali, 133 
Juniper berries, 551 

oil, 551, 552 

Kentish ointment, 711 

Keyser's pill, 519 

Kino, 552 

Knapp, Dr., his new views of disease, 

563 
Kousso, 553 

dose of, 553 

properties, 553 
Krameria triandria, 711 
Kreosote, 388 

Lactucarium, 553 
Lapis infernalis, 681 
Lard, poisoned, 143 
Larkspur, 554 

medicinal uses of, 554 
Laudanum, common, 616 

Battley's, 617 

Quaker's, 616 

Rousseau's, 617 

Sydenham's, 616 
Laurus camphora, 263 

sassafras, 555 
Laxatives, 285 
Lead, 659 

acetate of, 662-664 

carbonate of, 661 

colic, 670 

Goulard's extract, 660 

iodide of, 665 

oxides of, 659 

paint for burns, 661 

plaster, 660 



Lead poison, 666-678 

sheet, 659 

tannate of, 665 
Leeching, 556, 557 
Lemon acid, antacid, 559 

antiscorbutic, 559 
Lemonade powders, 93 
Lemons, juice how preserved, 558 

syrup of, 558 

use of, in dropsy, 559 
fevers, 558-561 
hemorrhages, 558 
influenza, 560 
rheumatism, 562 
scurvy, 559, 563 
Leucorrhaea treated with 

colchicum, 371 

creosote, 393 

cubebs, 400 

galls, 476 

green tea, 788 

iron, 460 

kino, 552 

nitrate of silver, 183 

pomegranate, 707 

rhatany, 713 

sulph. cupri, 411 
Ley, poisonous, 682 
Lichen Icelandicus, 557 
Lime, carbonate of, 254 

chloride of, 255 

liniment of, 254 

muriate of, 261 

phosphate, 261 

pure or quick, 253 

sulphuret, 261 

water, 253 
Liniments, 564, 565 
Lini usitatissimi, 564 

poultice of, 564 
Liquid ammonia, 124 

medicinal uses, 125 

poisonous, 126 

properties, 125 
Liquor of hydriodate of arsenic and 
mercury, 521, 522 

opii sedativus, 617 
Liriodendrine, 566 
Liriodendron tulipif., 565 
Litharge, 659 
Liver of sulphur, 780 
Liverwort, 566 
Lobelia inflata, 567 

bed of the leaves, 570 

medicinal uses, 568-570 

saturated tincture, 569 

therapeutic powers, 567 
Local bleeding, 570 
Logwood, 486 
Lotions of Prussic acid, 68 
Lozenges, 570, 571 



XV111 



CONTENTS AND INDEX. 



Lunar caustic, 178 

how made, 178 

uses of, 178-189 
Lugol's solution, 541 
Lupuline, 489 

Madder, 728 
Magnesia, 571 

calcined, 571, 572 

carbonates, 572-574 

citrate of, 576 

sulphate of, 575, 576 
Magnolia, 577 

substitute for Peruvian bark, 57: 

substitute for tobacco, 578 
Mandrake, 583 

Manganese and its salts, 579-581 
Maranta arundinacea, 581, 582 
Mastic, 582 
Matico, 582 
May apple, 583, 584 
McMunn's elixir of opium, 617 
Meadow saffron. 364 
Meat biscuit, 584-586 

poisoned, 142, 143 
Medicine man of the Indians, 45 
Medicinal Prussic acid, 64 
Medicines, modus operandi, 27 
Mel, 586 
Mentha, 586 

cigars, 511 
Mercurial ointment, 494, 495 

poison, 508, 509, 515-518 

pulse and fever, 505 

salivation checked, 510 

trembling, 491 

water, 492 
Mercury, 490 

acetate of, 518 

black wash of, 510 

chlorides of, 497 

cyanides of, 519 

found in human tissues, 493 

how purified, 492 

iodides of, 520, 521 

nitrate of, 517 

oxides of, 493 

poisonous, 491 

sulphate of, 516 

sulphurets of, 519 

yellow wash of, 510 
Mesmeric electricity, 586 
Milk, 586 

sickness, 587-591 
Mistura ferri composita, 457 
Mixtures, 591-594 
Modus operandi of medicines, 27 
Molasses, 594 

uses of, 595 
Monesia, 595 
Monkshood. 93 



Morphia, salts of, 618, 619 

sulphate of, 618 

suppository of, 620 

very minute doses of, 619 
Moschus, 596 
Moxa, 597 
Muriate of lime, 261 
Muriatic acid. (See Acid, Hydrochloric. 
Mushrooms, 597-600 
Musk, 596 
Mustard emetic, 745 

plaster, 746 

seeds, 745 
Myrrh, 600, 601 

Naphtha, 601 
Narcissus pratorum, 601 
Narcotics, 602 
Narcotine, 602 
Nickel, 602 

sulphate of, 602 

uses and doses, 602 
Nicotiana tabaci, 602 

injections of, 605 

medicinal uses of, 605-608 
Nipples, excoriated, treated with 

acid pyroligneous, 57 

argent, nitrat., 181 

catechu, 283 

collodion, 375 

tannin, 92 
Nitrate of mercury, 517 

potash, 687 
Nitric acid, 73-86 

ether, 449 
Nitro-muriatic acid bath, 82 
Nitrous powders, 689 
Nulla medicina, 608 
Number six, 280 
Nux vomica, 609, 763, 768 
Nutgalls, 475 

Oak bark, 710 

Oil of vitriol, 86 

Oils, 609 

Ointments, 609 

formulee for, 609, 610 

Oleum jecoris aselli, 348 

Olea, 610, 611 

Opium, adulterations of, 612 
antidotes of, 637 
cultivation of, 612 
cumulative power of, 634 
denarcotized, 615 
eating, 631-633 
effects of an overdose, 635 
improper for infants, 630 
largest dose on record, 629 
liquid preparations of, 616, 617 
medicinal uses of, 620-630 
natural history, 612 



CONTENTS AND INDEX. 



XIX 



Opium, novel mode of using, 629 

poison, 638, 639 

salts of, 614, 618, 619 

signs of genuine, 612 

therapeutic powers of, 620-630 
Origin of intestinal worms, 152 
Oxalic acid mistaken for Epsom salt, 

575 
Oxide of potassium, 681 
Oxygen gas, 639 

medicinal uses of, 640 
Oxymuriate of mercury, 510 
Ozonoid sulphur pills, 777 

Pad blister, 271 
Palliative treatment, 641 
Panacea, 641 
Papaver somniferum, 611 
Paregoric elixir, 618 
Pareira brava, 642 
Parisian freckle water, 562 
Parrish's mixture, 265 
Parthenium integrif., 327 
Paullinia, 643 
Peach leaves, 66 

anti-emetic, 66, 67 

best form of Prussic acid, 67 

decoction, how made, 66 

medicinal uses, 66, 67 

poultice of leaves, 66 
Pellitory of Spain, 644 
Pepsin, 644 

how made, 645 

nature of, 644 

uses of, 644 
Percussion, 646 
Peristaltic persuaders, 716 
Permanganate of potash, 697 
Perpetual blister, 274 
Phloridzine, 646 
Phosphate of ammonia, 138 

doses of, 139 

uses in gout, &c, 138 
Phosphorus, 647-650 

ethereal solution of, 647 

poison by, 648 
Phytolacca decandra, 650-652 
Pickles poisoned by copper, 402 
Pilulse, 652-657 
Pimento, 657 
Pink-root, 759 
Piperis nigri baccse, 657 
Piperine, 657, 658 
Pipsissewa, 707 
Pistacia lentiscus, 658 
Pitch plasters, 51 
Pix liquida, 658, 659 
Plumbum, 659-678 
Podophyllum peltatum. (See May 

Apple.) 
Poisoned butter, 671 



Poisoned cheese, 671 

preserves, 670 

sugar, 671 

water, 667 

wine, 672 
Poisoning at Washington, 198 
Poke root, 650, 652 
Polygala senega, 679, 680 
Polygonum hydropiper, 680 
Polypodium filix mas, 681 
Pond's pain extractor, 488 
Poppy, 611 
Potash, 681 

acetate of, 694 

bi-carbonate of, 687 

carbonate of, 685 

caustic or pure, 681 

chlorate of, 694-696 

citrate of, 687 

ferro-cyanate of, 696 

liquor of, 685 

nitrate of, 687 

permanganate of, 697 

sulphate of, 693 

tartrates of, 691 
Potato, 697 

starch, 699 
Poultices, 699 
Powders, 704-706 
Precipitate per se, 497 
Preparatory treatment of fevers, 307 
Prescriptions, 700 
Preventive treatment, 702 
Prophylactic treatment, 702 
Proteine, 703 

composition of, 703 

how obtained, 703 

nutritious, 703 

use as medicine, 703 
Protoxide of mercury, 521 
Prunus Virginiana, 703 
Pruritus, treated with 

acid hydrocyanic, 68 

borax, 753 

calomel, 506 

collodion, 374 

lemon-juice, 562 

starch and camphor, 267 

warm water, 175 
Prussic acid. (See Acid, Hydrocyanic.) 
64 

medicinal uses of, 66-69 

poison, how detected, 66-70 
Pulsatilla, 704 
Pulveres, 704-706 
Pulvis antimonialis, 164 
Pumpkin seeds, 706 

remedy for taenia, 706 
Punicse granati, 706 
Pure chemicals, 707 
Purgatives, 285 



XX 



CONTENTS AND INDEX. 



Pyri cydonis sein., 707 
Pyrola umbellata, 707 
Pyroligneous acid, 56, 57 

Quaker's drop, 616 

Quassia, 708 
cup, 708 

Quercus, 709 

Quicksilver, 490 

Quiniue amorphous, 710 
arseniate of, 325 
citrate of iron and, 325 
disulphate of, 302-323 
ferrocyanate of, 325 
glycerine solutions of, 326 
how obtained, 326 
hydrochlorate of, 325 
phosphate of, 325 
poison of, 323, 324 
tannate of, 325 
valerianate of, 326 

Quininism, 304 

Quinodine, 710 

Rapid cure of itch, 779 
Ready method of Mr. Hall, 711 
Red precipitate, 496 
Remedial treatment, 798 
Resina flava, 711 
Rhatany, 711, 712, 714 
Rhei radix, 714, 718 
Rheumatism, treated with 

camphor, 267 

cod-liver oil, 360 

colchicum, 368 

copper, 400 

croton oil, 398 

Dover's powder, 548 

guaiacum, 483 

henbane, 523 

hydriodate of potash, 538 

lemon-juice, 561, 562 

magnolias, 578 

mustard, 745 

nitrate of potash, 690 

opiates, 624 

pokeroot, 651 

prickly ash, 807 

resina flava, 711 

serpentaria, 745 

sulph. quinine, 319 

sulphuret of carbon, 781 

sulphur tea, 777 

sulphur vapor bath, 780 

turpentine, 793 
Rhubarb, 714 

calcined, 718 

frauds in sale of, 715 

powder, 715 

root, 714, 715 

spiced, 717 



Rhubarb, syrup of, 717 

tea, 716 

varieties of, 714 
Rhubarbine, 715 
Rhus toxicodendron, 718 
Ricini oleum, 718 

modes of taking, 719 
Ricinine, 722 
Rose-water, 722 
Rosmarinus, 722 
Rosemary, 722 
Routinism, 722 
Rubefacient, 279 
Rubia tinctorum, 723 
Rubus trivialis, 723 

villosus, 723 
Rue, 724 
Rumex, 724 
Rush's pills, 507 

fever powders, 506, 689 
Ruspini's styptic, 724 
Ruta graveolens, 724 

Sabina, 725 

Saccharum saturni, 662 

Sachets, 726 

Sago, 726 

Saint John Long's ointment, 727 

Sal absynthii, 685 

ammoniac, 131 

prunelle, 691 
Salep, 727 
Salicine, 727 
Salix, 727 
Salt of tartar, 685 

of wormwood, 685 
Saltpetre, 687 
Sambuci flores, 728 

radix, 729 
Sanguinaria Canad., 729, 731 
Sapo, 731 
Sarsaparilla, 732 

compound syrup of, 732 
Sausages, poisoned, 142 
Savine, 725 

oil of, 725 

ointment, 726 

poisonous, 725 

powder of, 726 

properties of, 725 

uses of, 725, 726 
Scabious, 732 
Scammony, properties of, 733 

uses of, 733 
Scarlet fever, treated with 

belladonna, 236 

bole armenian, 190 

chlorate of potash, 695 

chloride of soda, 755 

chlorine, 291 

cold water, 170 



CONTENTS AND INDEX. 



XXI 



Scarlet fever, treated with 

hyd. potash, 539 

lard, 101 

mineral acids, 72 

muriate of soda, 55 

pyrolig. acid, 57 

tobacco, 607 

warm water, 176 
Scilla, 734, 735 
Scutellaria laterifolia, 735 
Sea onion, 734 
Secale cornutum, 735 

cautions in using, 736 

medicinal uses of, 736, 737 

natural history of, 735, 736 

poisonous, 738 

properties of, 735, 740 

uva ursi a substitute for, 740 
Sedative cathartic, 396 
Sedatives, 741 
Semola, 741 
Senna, 742 

figgy, 744 

preparations of, 742, 743 

varieties of, 742 
Seneka snakeroot, 679, 680 
Serpentaria Virginiana, 744, 745 
Sialagogue action of mercury, 505 
Silver, uses in medicine, 178-188 
Sinapis, 715 
Sinapisms, 746 

cautions in use of, 746 

how made, 746 
Skate-liver oil, 348 
Slippery elm, 802 
Skunk cabbage, 526 
Snuff, 603 

Soap, used in burns, 732 
Soap liniment, 732 
Soda, baths of, 749 

benzoate of, 757 

bi-borate of, 751 

bi-carbonate of, 750 

carbonate of, 747 

chloride of, 754, 757 

muriate of, 751 

phosphate of, 754 

poultices of, 749 

tart, of pot. and, 754 

silicate of, 757 

source of, 747 

sulphate of, 753 

water, how poisonous, 750 
Solanum dulcamara, 758 

tuberosum, 697 
Soluble tartar, 693 
Solutions, 758 
Soot, 758 

tea, 759 
Spice plaster, 327 
Spider's web, 788 



Spigelia marilandica, 759 

cautions in use of, 760 

how employed, 760 

what parts best, 759 
Spiritus mindereri, 135 

how made, 135 

incompatibles, 138 

medicinal uses of, 136-138 

properties of, 136, 138 
Spongia officinalis, 760 
Sponge pessaries, 760 

tent, 760 
Spoons for dispensing, 761 
Spurious barks, 298 
Spurred rye, 735 
Squill, 734 

acetous tincture of, 735 

oxymel and syrup of, 735 

properties and uses, 734, 735 
Starch, iodide of, 542 
Steer's opodeldoc, 732 
Stethoscope, 762 
Stimulants, 762 
Stinging nettle, 802 
Stramonium, 413 

extract of, 415 

medicinal uses of, 415, 416 

poisonous, 413, 414 
Strychnia, 763 

antidotes for, 775 

doses, 769 

how obtained, 764 

igasurate of, 764 

its action, 765 

largest dose known, 776 

poisonous, 772-774 

tests for, 774 

uses of, 769, 771 
Strychnos mix vomica, 763 

St. Ignatius, 763 
Styptic of Ruspini, 724 
Sugar of lead, 662, 664 
Sulphate of copper, 409 

uses of, 410, 411 
Sulphate of quinine, 302 

a di-salt, 302 

adulterations of, 322 

antiseptic, 326 

bitterness obviated, 302 

cuts fevers short, 303, 313, 317 

dose how regulated, 305 

endermic use of, 303 

forms of exhibition, 302 

large doses of, 303-306 

poisonous, 323, 324 

preparatory treatment, 307 

prophylactic, 313-315, 316, 318, 
320 

pulse how affected, 317-326 
Sulphur, 776 

flowers of, 776, 777 



XX11 



CONTENTS AND INDEX. 



Sulphur, medicinal uses of, 777, 780 

ointment of, 779 

pills, 777 

roll, 777 

tea, 777 

vapor bath, 780 
Sulphurets of mercury, 519 
Sulphuret of potash, 780 

carbon, 781 
Sulphuric acid, 86 

lemonade, 89 
Sumbul, 782 
Suppository, 782 
Swaim's panacea contains mercury, 

511 
Sweet fennel, 456 
Sweet spt. of nitre, 449 
Syphilis cured without mercury, 522 
Syrups, formulae for, 782, 783 
System, state of the, 783, 785 

Tanacetum, 785 
Tannic acid, 91 

medicinal uses of, 92 
Tannin, 91, 786 

how obtained, 91 

properties of, 92 
Tansy, 785 

oil of, poisonous, 786 
Tapioca, 786 
Tar, 658 

Taraxacum, 786, 787 
Tartar emetic, 156 

antidotes, 164 

contra-stimulant, 160 

immense doses, 161 - 

poisonous, 164 

tolerance of, 160 

why it fails to vomit, 164 
Tartaric acid, 93 
Tea plant, 787 

dietetic uses of, 788 

medicinal uses of, 788 

properties of, 787, 788 

varieties of, 787 
Tela aranearum, 788 
Terebinth oL, 789 
Thebaic tincture, 616 
Theine and caffeine, 362 
Therapeutics, 794 
Thermic treatment, 795 
Tinctures, 795 
Tinea capitis, treated with 

calomel, 506 

carb. soda, 749 

cerate of Belleville, 507 

charcoal, 281 

chlorides, 259 

citrin ointment, 518 

cocculus indicus, 347 

creosote. 389 



Tinea capitis, treated with 

lunar caustic, 183 

oak bark, 710 

oil of juniper, 551 

pyrolig. acid, 57 

sanguinaria, 731 

spt. mindereri, 138 

sugar of lead, 663 
Tobacco, 796, 602 

bath of, 606 

injections, 605, 606 

medicinal uses of, 604, 607 

poultices, 608 

poisonous, 603 
Tokens, pharmaceutic, 49 
Tolerance, 160 
Tomato, 796 
Tonic powders, 457 
Tonics, 797 
Tormentilla, 797 

use in hemorrhage, 797 
Tous les mois, 797 

Treatment, empirical and rational. 
798 

palliative, 798 

preparatory, 798 

prophylactic, 798 

remedial. 798 
Trephining, 799, 800 
Tris-nitrate of bismuth, 239 
Turlington's balsam, 219 
Turner's cerate, 811 
Turpentine, oil of, 789 

poisonous, 791 

properties, 789, 792 

spirit of, 789 

uses of, 789, 792 
Turpith mineral, 516, 517 

Ulmus, 802 
Unicorn root, 488 
Urtica dioica, 802 

use in skin disease, 802 
Uva ursi, 803 

Vaccinium oxycoccos, 803 
Valerian, 804 
Vanilla, 804 

medicinal use of, 805 
Vegetable alkali, 681 
Veratria, 371, 372 
Veratrum album, 805 

niger, 805 

viride, 805, 806 
Verdigris, 401 
Vienna paste, 806 
Vinegar, nature of, 55 

poisonous, 58 

uses of, 56, 57 
Vitriol, blue, 409 

green, 461 



CONTENTS AND INDEX. 



XXlll 



Vitriol, white, 818 
Volatile julep, 138 

liniment, 254 

salt, 182 
Vomiting, treat ed^with 

calumbo, 252 

coffee, 368 

creosote, 391 

hydrocy. acid, 68 

larkspur, 554 

naphtha, 601 

peach leaves, 66 

wine, 159 

Water, accidental cures by, 169, 170 

boiling, 175 

burns treated with, 174 

cure, 806 

fevers cured by, 168 

mineral, 176 

mercurial, 492 

pepper, 680 

use in Asiatic cholera, 170 

use in delirium tremens, 172 

scarlatina, 170 
Whey, alum, 123, 807 

wine, 807 
Whisky, 807 
White dose, 574 

hellebore, 805 



AVhite oxide of bismuth, 239 

precipitate, 518 

vitriol, 813 
AVild cherry, 703 
Wines, poisoned, 112, 118 
Winter green, 707 
Witch hazel, 807 
Wormseed, 289 
Wormwood, 52 

salt of, 685 

Xanthoxylon, 807 

Yeast, 808 

medicinal use of, 808, 810 

nature of, 808 

properties of, 810 
Yellow dock root, 724 

Zinc, for galvanic uses, 810 

medicinal uses of, 811, 818 

not fit for culinary use, 818 

oxides of, 810 

preparations of, 811, 818 
Zingiber, adulteration, 820 

essence of, 819 

powder of, 820 

preparations, 819 

syrup of, 819 

use of, 819, 820 



INTRODUCTION TO THE FIRST EDITION, 

WITH EMENDATIONS. 



The work now offered to the medical public contains the 
substance of the author's lectures on Materia Medica and Thera- 
peutics, as delivered in the Medical Department of Transylvania 
University, in eleven successive winters. His uninterrupted 
researches into the various sources of information, aided by his 
own experience, have enabled him to embody a large amount of 
practical information, which he regards equally reliable with any 
other stock of knowledge to which practitioners have access. And 
if, in some sense, the present performance may claim to be supe- 
rior to other books on the same topics, the difference will be found 
to consist, chiefly, in the fact that the author has given to his 
work a much more practical character, and has fitted it the bet- 
ter for the daily reference of those who are engaged in the practi- 
cal duties of the profession. This remark refers not only to 
ordinary practice, but to the right management of the more com- 
mon cases of poisoning. 

But there is still another point of difference between this and 
other books of Materia Medica and Therapeutics, which some may 
not approve. I allude to the small amount of dry details on the 
natural, botanical, and chemical history of articles to be found in 
this work. It has always appeared to. me to be unnecessary, and 
actually uninstructive, to swell a volume to an inconvenient bulk 
by the statement of facts that not one in a thousand will take the 
trouble to read. I have, therefore, purposely excluded a great 
deal that some have seemed to think essential to the structure of 
a treatise on this department of medical science, preferring to fill 
the pages with really useful, practical matter, of every-day interest 
in all parts of the country. On the same principle, several articles 
have been briefly noticed that cannot be found in other works ; 
as, for instance, Depuration and Elimination, so ably explained 
and applied by Drs. Todd and Golding Bird. . 

3 



26 INTRODUCTION. 

The arrangement of the work is exactly after the manner of 
the author's lectures. When he commenced the task of teaching 
in this department, he hesitated whether he should adopt some 
system of classification, or treat the articles on the strictly alpha- 
betical plan. He knew that the late Professor Eberle had adopt- 
ed the latter, in his lectures on Materia Medica, in the Medical 
College of Ohio, and this was in the nature of authority; and the 
more he studied the history and facts of classification, the more 
entirely was he satisfied that it was not the best plan either for 
the teacher or the pupil. He discovered that the highest autho- 
rities, even after adopting a system of classification, were forced 
to concede its defects, and the utter impracticability of construct- 
ing a perfect system. He felt, too, that the alphabetical arrange- 
ment had a decided advantage in respect of new remedies, which 
could not be classified without a reasonable delay to test their 
powers, while they could most naturally fall into their proper 
position in the alphabet. 

After an experience of eleven years in the use of the alpha- 
betical arrangement, the author is compelled to affirm that it 
seems to him, in every view of the case, the best plan for the study 
of Materia Medica and Therapeutics. It not only meets the 
case of all additions to the stock of remedial agents, but it allows 
more ample scope and range in the investigation of all old articles. 
He has found it quite important and instructive to teach under 
one head, as opium, all that is worthy of note concerning that 
medicine, in all its varied relations; far better to dispose of it 
thus than to treat of it under the separate and distinct classes 
usually named in the books. 

On no point is the author more thoroughly satisfied, than that 
the pupils taught by him after this plan are as fully informed on 
all the points that merit study as they could be if instructed on 
the classification method ; if there be a balance either way, it is 
decidedly in favor of the alphabetical arrangement. He has been 
in the habit,, occasionally, of quizzing the pupils under the several 
heads of the classified Materia Medica, and they have been found 
to be as familiar with the subject as if that method had been chosen 
by the writer rather than the other. 

Any one who will patiently study Dr. Headland's account of 
some six or eight systems of classification, as it may be seen in 
his excellent book on the action of medicines, not excepting the 
Doctor's own plan of classifying remedies, I think will perceive that 
this thing of putting remedies into classes is environed with innu- 
merable difficulties. After giving details to illustrate his Hcema- 
tica, Neurotica, Narcotica, Sedantia, Astringentia, and Elimi- 
nantia, he has sixty pages to account for the action of agents that 
this new and comprehensive plan failed, as he admits, to explain 



INTRODUCTION. 27 

satisfactorily. Among these are Cod-liver Oil, Iodine, Quinine, 
Colchicum, &c. &c, which put all systems of classification at 
utter defiance, just because no one yet fully understands their 
modus operandi. The plan adopted by the author of this work 
gives him what the other does not, viz. : ample, theoretical, elbow- 
room ; and it is, in point of facility of study, vastly preferable, 
both for public teachers and pupils in attendance on lectures. 

Having hinted at the plan of classification by Headland, as we 
find it in the last edition of his book on the action of medicines, 
(1857,) we may as well introduce a brief view of it here, regard- 
ing it, as we do, as the best yet submitted to the profession. 

CLASS I. — Haematics or Blood Medicines. 
Division 1. — Restoratives, as iron in anaemia. 
Division 2. — Catalytics,* as mercury in syphilis. 

CLASS II, — Neurotics or Nerve Medicines. 
Division 1. — Stimulants, as ammonia. 
Division 2. — Narcotics, as opium. 
Division 3. — Sedatives, as hydrocyanic acid. 

CLASS III. — Astringents, as tannic acid. 

CLASS IV. — Eliminatives, as cantharides and croton oil. 

If we ever change our present purpose, this plan, slightly modi- 
fied, will be selected, as the basis of our public teaching in this 
department. 

Having thus briefly assigned my reasons for preference of the 
alphabetical arrangement, it is proper to say a few words on the 
modus operandi of the articles of Materia Medica. And we 
confess, most candidly, that we know very little on this subject, — 
almost nothing that merits the title of accurate and demonstra- 
tive. In our judgment, very many points in this relation, deemed 
by many as settled, are yet, fairly and literally, matters to be 
determined. The profession has been too self-confident, and is 
yet to be shorn of some of the imaginary honors it has worn for 
years. 

Very many considerations appertain to a full estimate of the 
action of remedies in the cure of disease which call for very care- 
ful notice. In attempting to analyze these, we are apt to be in- 
fluenced too much by attachment to some favorite system or 
theory ; and whenever our efforts are conducted under such feel- 
ings, we rarely elicit the truth. < 

We remark, further, that there seems to be a pretty general 

* This term gives the idea of breaking up, or destroying, or greatly altering 
morbid matter, so as to be ready to be carried out of the body by the elimina- 
tives. 



28 INTRODUCTION. 

agreement on certain points which attach to such an investigation. 
Thus, it is held that some agents exert a direct influence on what 
we call the solid fibre ; that others act primarily on the nervous 
system ; that others enter the general circulation and so influence 
the quality of the blood; that others undergo decomposition in 
the stomach as preliminary to their full action ; that others gain 
their appropriate results on the principle of revulsion ; while a 
very few seem to depend wholly on chemical agency for whatever 
they accomplish. 

In regard to the first link in this chain, viz., the direct action 
exerted by some medicinal agents on the living system, we remark 
that these agents do sometimes set up actions that are, apparently 
at least, purely local at the first. We do not mean to say that, 
after this purely local effect, there may not be developed another, 
in virtue of sympathy, or rather by reason of nervous relation- 
ship. Certain astringents, taken into the stomach, or thrown into 
the rectum, have a direct influence on the animal fibre, producing 
corrugation or actual condensation. To a certain extent, this is 
just as obvious as the action of astringents in the process of tan- 
ning. Every boy has felt this to be so when he has incautiously 
undertaken to eat some half-ripe persimmons. 

On the principle just adverted to, we often employ astringents 
in the treatment of diarrhoea which may owe its continuance to 
simple relaxation of the alimentary canal. The tissue of the 
part of the intestines more immediately implicated is subjected 
to a positive physical alteration, and that is, primarily, the appro- 
priate operation of the remedy. If, by this local action, a more 
healthful state of the particular part is established, its nervous 
associations will, as a consequence, be more in accordance with 
the phenomena of health. All such remedies, therefore, exert 
the simplest, most unmixed kind of agency ; so much so, indeed, 
that some have called it a mechanical action. But in this they 
err manifestly, since no mere mechanical action can be conceded 
in a body whose every movement is directed by vital laws. Every 
action being essentially vital, all the results must be vital also. 

But there are remedial operations of a much more complex 
nature, and, therefore, far less easy of solution. This is specially 
true of all medicines that act primarily on the nervous energy or 
system. And here we are forced to employ terms which, con- 
fessedly, we do not fully comprehend. What mean we by nervous 
energy ? All that we can reply is, that it imports that peculiar 
faculty of the great system of nervous matter (including the brain 
and spinal marrow) on which is founded the well-known susceptibility 
of the animal in respect of impressions of every grade and kind. 
A thousand facts assure us of this susceptibility, and as it must 
have a basis, we fix it here, and suppose we are right. This 



INTRODUCTION. 29 

nervous energy is believed to be extremely subtle, so as to resist 
mathematical demonstration altogether, and yet environed with 
facts wholly inexplicable apart from the dominant influence of 
this principle. Thus, a medicine is put into the stomach, acts on 
that organ, and almost immediately an obvious result is noticed 
at some distant point, or perhaps the entire system feels the shock. 
The sixteenth part of a grain of tartar emetic taken into the sto- 
mach, though not, perhaps, felt by that organ, will, in a moment, 
cover the cutaneous surface with perspiration. This result, so 
often witnessed, depends on the propagation of a peculiar influ- 
ence through the medium of the nervous energy or power. We 
have no other mode of explanation to meet the case. If remedies, 
whose operation extends beyond the stomach too speedily to allow 
of a passage through the blood, do not depend for action on a 
nervous medium, we are unable to perceive to what else it can be 
fairly attributed. Conceding this connection, it is not difficult to 
understand how impressions are propagated to distant parts, so 
as to involve the whole system. Modern investigations into the 
intricacies of the nervous system have shown, with tolerable clear- 
ness, how impressions may be communicated along certain sets of 
nerves, while others remain unaffected. In this way, we learn 
the cause of those associated changes that are of simultaneous 
occurrence in parts remote from each other. All the nerves of 
sensation originate in a common medullary tract, — in the spinal 
marrow and brain ; a similar medium of communication unites 
the nerves of motion or volition, and a third, those of respiration. 
Now, if an impression be made on a nerve belonging to any of 
these sets of nerves, it is carried to the whole set to which the 
affected nerve belongs by the common medium. Thus, if a vio- 
lent pain be in the great toe, as in gout, we know that a full dose 
of opium will allay, perhaps annihilate it. No one thinks that 
the opium is taken up by the absorbents, and carried by the blood- 
vessels to the great toe, in order to make its impression there. 
If, perchance, any one can be found who cherishes such an 
opinion, most assuredly he is welcome to all the profit of such a 
notion. We think the opium acts on the sentient extremities of 
the gastric nerves of sensation ; that the peculiar effect there in- 
duced is carried to the connecting tract of the spine and senso- 
rium commune, and thence to the seat of suffering. Here is 
obviously, then, an action almost, perhaps quite, simultaneous in 
some of the nerves in parts very remote from each other ; and 
this fact is well established by associated impressions so often 
observed in the progress of disease. 

As further illustrative we give the following case : — A patient 
labors under distressing palpitation, and on applying the hand 
over the cardiac region, a violent beating is detected. The case 



30 INTRODUCTION. 

may have been hastily examined by some one who pronounced it 
to be real heart disease. But, on a very careful observation of 
accessible points, you perceive that the heart is not diseased, its 
structure is not at all involved. You find the stomach to be at 
fault, and you justly conclude that the distress complained of in 
the region of the heart has a gastric origin exclusively. What 
is to be done ? The heart and stomach occupy different regions. 
How then can it be that the heart suffers in any sense because 
of primary gastric disorder ? We reply, in the use of professional 
parlance, that the heart sympathizes with the unhealthy state of 
the other organ. In this view of the case, we apply our remedies 
not to the heart, but to the stomach. In truth, we have no 
remedy that can directly influence the heart, as we can and do 
influence the stomach. We aim, therefore, at soothing the morbid 
irritability of the stomach, and this being accomplished, the heart 
becomes tranquil, regains its wonted natural action. 

In our judgment, the cases last cited are valid proofs of the 
action of remedies through a nervous medium, apart from the 
concurrence of absorption into the mass of blood. But we have 
yet another case, which, while it proves satisfactorily that some 
medicines may affect the system through the blood as well as 
through the nerves, also evinces that they do sometimes produce 
their effects wholly apart from the process of absorption. An 
adult takes a full dose of rhubarb in the customary way, and is 
purged in due season. If you examine his urine, you can detect 
the rhubarb there ; and the inference is justly made, that the 
medicine has traveled through the circulatory system — that of 
course it was taken up by the absorbents. But apply a strong 
poultice of rhubarb to the abdomen of a child, and in due season 
you get the same kind of purgation that was realized in the adult; 
yet the rhubarb cannot be found in the urine. That the medicine 
has truly purged the child, is undoubted ; yet it has not traveled 
in the route of the circulation, nor has it permeated the walls of 
the abdomen. How has it acted, if not by a nervous medium ? 
It will not do to say that the action was merely mechanical, or 
the effect of increased temperature in the poultice ; else why not 
purge the child as certainly by a cataplasm of bread and milk ? 

As a further illustration, we cite a well-known experiment per- 
formed by Dupuy. He divided the eighth pair of nerves in a 
horse, and introduced into the stomach two ounces of nux vomica, 
with no bad result. The same quantity, given to a similar horse 
with the nerves untouched, induced violent tetanic convulsions, 
and in a short time death. The inference is irresistible, therefore, 
that many remedial agents exert their force on the economy 
through a nervous medium, aside from absorption. 

We know that Headland, with others, insists on the fact, ascer- 



INTRODUCTION. 31 

tained by experiment, that medicines pass through the okculation 
with vast rapidity, and that these supposed cases of actio* through 
the nervous system are all effected by the flowing blood. His 
language is, " There is no poison, whatever, which acts so quickly 
on distant parts that the circulation cannot previously have had 
time to conduct it thither." Dr. Blake found that a chemical 
substance traversed the entire circulation of a horse in twenty 
seconds. 

In the statement and illustration of the foregoing position, we 
do not pretend to deny that medicines are absorbed and carried 
through the circulation, and thus exert their power. We know 
that experiments have been made in proof of the position that, 
after all communication was severed by the knife, the blood-ves- 
sels divided, and the circulation maintained by quills to which the 
ends of the vessels were secured, a poison inserted under the skin 
of the severed limb induced all its usual deleterious effects in the 
animal. Here the result flowed from absorption and admixture 
of the poison with the blood. 

But it may well be demanded, who has ever yet accounted for 
the different actions of remedies on nervous structure ? How is 
it that opium contracts the pupil, while belladonna dilates it ? 
How does digitalis induce its special action on the heart ? What 
is the modus operandi, — not by conjecture, but in reality ? It 
is utterly impossible to answer. And yet some in the profession 
talk as confidently about these, and others of like character, as if 
the problems were quite as obvious as that two and two make four. 

In whatever way the nervous communication of which we have 
been speaking takes place, there are three surfaces on which im- 
pressions may be successfully made, and thence propagated to 
other parts. The first includes the stomach and alimentary canal; 
the second is the skin; the third is the organ of smelling. 

That the stomach is very largely supplied Avith nerves, and is 
highly irritable, is a fact known to every one. Its cavity through- 
out is endowed with the power of receiving and diffusing impres- 
sions, and hence it has been called the great centre of sympathy. 
Hence the advantages growing out of the medium it offers for 
operating on parts remote. We give medicine, frequently, with 
a view to action on distant parts, which make no sensible impres- 
sion on the stomach itself, although we make it the medium of 
operation. But if the stomach be the subject of diseased irrita- 
tion, it is exquisitely susceptible to the impression of remedial 
agents, and sometimes becomes a focus in which morbid impres- 
sions are concentrated from other parts. 

The large intestines, moreover, possess a vast amount of ner- 
vous energy, derived from nerves connected with the great sym- 
pathetic ; and from impressions made on their extensive surface 



32 INTRODUCTION. 

by niedkkial agents, an impulse is imparted to the system at 
large neaRy in the manner, though not with the same force, we 
notice when the stomach is the organ first acted on. Hence we 
throw with safety much larger portions of medicine, and more 
acrid articles, into the rectum, than we are permitted to place in 
the stomach. Owing to similarity of surface, so far as nervous 
energy is concerned, we get the same results, in kind if not 
in degree, from articles thrown into the rectum as from the 
same articles put in the stomach. Indeed, there are cases in 
which it is decidedly better to administer remedies by the rectum 
than by the mouth. Sometimes the stomach, from its great irri- 
tability, will not bear a medicine that will give the result desired 
when passed into the rectum, and without at all annoying the sto- 
mach. It is often necessary to resort to this method, as for the 
administration of laudanum, assafetida, &c. &c. 

We have already hinted at the profusion of nerves distributed 
on the surface of the body, in consequence of which it is endowed 
with a large amount of sensibility; and although the cuticle, 
which has no sensibility, be interposed between the true or sensi- 
tive skin and any medicinal substance that may be applied to the 
surface, yet the skin is readily excited, and through it a sympa- 
thetic action is imparted to the rest of the system. Hence the 
ease with which impressions are made on the surface by medicinal 
agents. Notwithstanding the palpable nature of this truth, some 
sensible men have denied the efficacy of this mode of treatment, 
because they rejected the doctrine of cuticular absorption. But 
from much experience in the management of infantile patients, I 
learned abundantly the facility of operating on the entire system 
by remedies applied to the surface. We have already spoken of 
the efficacy of rhubarb, applied to the abdomen of young chil- 
dren ; and other cases which occur to the reflecting mind. It is 
not necessary to look to cutaneous absorption for an explanation 
of the action of any remedy applied to the surface. The infini- 
tude of nervous filaments spread out in all directions will amply 
account for all the effects we observe. 

The third and last medium to which we referred for the recep- 
tion of impressions made on the nervous system by medicinal 
agents, is the organ of smelling. This is dependent on the first 
and fifth pair of nerves spread out on the Schneiderian mem- 
brane, whose extensive surface is admirably suited to this object. 
We are all aware how readily some persons are sickened by offen- 
sive odors, while others who have lost the sense of smelling are 
unaffected by contiguity with such objects. The influence of 
odors on the whole system, through the organ of smelling, is not 
sufficiently appreciated. Not a few agents exert their influence 
on the nervous centres through this organ, that have been sup- 



INTRODUCTION. 33 

posed to act by pulmonary absorption. Dr. Rousseau's experi- 
ments with persons blindfolded and the nostrils plugged, excited 
a good deal of interest in Philadelphia thirty-five or forty years 
ago. He affirmed that assafetida, camphor, &c, put into the 
mouths of such persons, and chewed, were not distinguishable 
from bread. He also declared that the vapors of alcohol or lauda- 
num might be inhaled without effect for a long while. Dr. R. 
believed that the organ of smelling was essential to the legitimate 
action of all these agents. 

Making all reasonable allowance for the well-known enthusiasm 
of Rousseau, his experiments forcibly teach the importance of 
the lining membrane of the nose as a surface on which to make 
medicinal impressions. We also understand how devotees to 
snuff deprive themselves of an important medium for the admi- 
nistration of remedies. The man who plasters his Schneiderian 
membrane with impervious coats of this article loses one avenue, 
at least, by which remedies should find an entrance to the system. 

That medicines may be absorbed, and travel in the circulating 
mass to all parts of the body, and exert their peculiar energy on 
the general system, few will deny. Three ways have been named 
for such conveyance, viz. : Absorption from the intestinal canal, 
absorption through the shin, and absorption through the lungs. 

Very decisive proofs have been furnished, to show that medi- 
cines are absorbed from the intestinal tube. Thus, if a person 
take a salt of iron, or prussiate of potash, we detect either in 
the urine in a few hours. Here it is obvious that these articles 
travel, unchanged in their essential properties, throughout the 
course of the circulation ; and, in order to get into the blood, 
they must needs be absorbed. It is well known that the exten- 
sive surface of the intestinal canal abounds with absorbent ves- 
sels, ready to take up articles carried there from the stomach or 
rectum, and thence to convey them into the mass of blood. 

In like manner, articles of food are absorbed from the intesti- 
nal canal, and the animal vigor is thereby preserved. Thus, 
patients have been supported for months, who could not have been 
nourished by the mouth in consequence of extensive stricture of 
the oesophagus, by means of nutritive clysters. The same thing 
has been done in respect of very young children, who for weeks 
were prostrated with irritability of stomach that forbade the in- 
troduction of nourishment by the mouth. If food can be made 
to enter the system thus, what can prevent the access of medicines 
by the same route ? 

Touching the absorption of medicines by the skin, we have 
little to offer of a satisfactory nature. That the true skin is 
plentifully supplied with nerves and absorbents, is undeniable. 
Its resemblance, in tins and other particulars, to the mucous lining 



34 INTRODUCTION. 

of the intestinal canal is so striking that anatomists have regard- 
ed the latter to be only a prolongation or extension of the former, 
modified to a due adaptation to the functions of the part it covers. 
But while the mucous membrane of the bowels is protected only 
by its appropriate secretion, the true skin is covered with the 
cuticle, which would seem to be placed there to obstruct the action 
of external agents, although, as we have seen, remedies applied 
to the surface are often decidedly efficacious through the inherent 
nervous energy. This is quite another thing from the absorption 
of medicines. 

The advocates of the doctrine of cuticular absorption have been 
numerous ; but it is not our purpose to enter into details touching 
their researches. We are inclined to think, from all the investi- 
gations we have been able to make, that absorption by the skin 
is restricted to very small surfaces of the body, and by no means 
extending to the entire skin. During the period of my attend- 
ance on medical lectures, a pupil from Georgia, who was regarded 
as a little " cracked," determined to prove, most conclusively, the 
doctrine in question. To this end he had a vast hominy bath 
made large enough to receive his body. He had long been fami- 
liar with the nutritive property of hominy, and believed he could 
be sustained by the absorption of it through the skin. He entered 
the bath like a genuine inquirer after truth, having arranged 
matters so as to keep his head entirely above the nutritive semi- 
fluid. I need not say that the experiment failed, for the poor 
fellow became distressingly hungry, and had abundant assurance 
that he could not be sustained in that way. 

There can be no doubt that medicines may find their way into 
the system, in an undecomposed state, by being absorbed or con- 
veyed through the lungs. Many experiments have been made, 
showing clearly that volatile substances may and do enter the 
system by this route. We are not certain that decomposition 
ever occurs in medicines that enter thus, nor is it at all necessary 
that such a change should occur. All such substances are carried 
into the lungs by the atmospheric air, which serves as an appro- 
priate vehicle ; and although the latter must be decomposed to 
subserve the purposes of respiration, it by no means follows that 
the volatile medicines conveyed by it into the lungs must undergo 
a like change. In fact, the occurrence of such a change might 
work serious mischief. There are absorbents in abundance open- 
ing on the mucous membrane of the bronchial tubes which readily 
take up all such volatile matters for the purpose of conveying 
them into the circulation. In this passage they often stimulate 
the nervous system powerfully, and sometimes produce an in- 
fluence on the body as real as if they had been taken into the 
stomach. 



INTRODUCTION. 35 

That medicines may be, and are, decomposed in the stomach is 
abundantly evident. After the decomposition, some of the con- 
stituents may be detected in distant parts of the system, or in 
some of the excretions, or they may act specially on the nervous 
system. There is proof that the coloring matter of some bodies 
is eliminated by the agency of the stomach. Thus, after an in- 
dividual has taken rhubarb, a few drops of a strong solution of 
potash added to the urine will throw down a lake color, proving 
the presence of the coloring matter of rhubarb in the excretion. 
So also the coloring matter of madder is detached, and may be 
seen in the bones, giving evidence of its passage through the cir- 
culatory system. 

It is more than conjectural that vegetable medicines are decom- 
posed as alimentary substances are ; and although they may 
sometimes make their impression on the nerves of the stomach 
prior to any radical change, yet it is no doubt true, as a general 
principle, that decomposition precedes the full development of 
medicinal energy, in virtue of which the active principle is sepa- 
rated from the digestible matter that it may act directly on the 
nerves of the stomach or find its way into the circulation. In 
this way we may rationally account for the length of time that 
often elapses, after medicine is taken into the stomach, before its 
operation is realized. Eor instance, a dose of ipecacuanha will 
ordinarily require thirty minutes, and occasionally a longer time, 
to act as an emetic, and the same is true of other articles. The 
delay is owing to the envelopment of the active principle of the 
medicine in some foreign or comparatively inert body — as wax, 
gum, starch, ligneous matter — which renders the digestive process 
necessary in order to a proper separation. 

But the decomposition of medicines in the stomach is not pecu- 
liar to vegetable matters. Salts, into whose composition vege- 
table acids enter, are subject to like change. The acetate of 
potash is separated into acetic acid and potash, the former being 
digested, and the latter entering the circulation to be conveyed 
out of the system by the kidneys. There can be no doubt that 
the decomposition is effected by the vital powers of the stomach, 
and that the active principle thus eliminated acts directly on the 
stomach, extending its influence by nervous sympathy to distant 
parts of the system ; or, that it is absorbed and carried in the course 
of the circulation to those organs on which its appropriate action 
becomes more apparent, whether it be diuretic, sudorific, or ex- 
pectorant. 

Besides the decomposition of medicines by the vital forces, a 
like change is effected by chemical agency. The acetic and 
muriatic acids exist in the stomach in variable quantities, derived 
chiefly from the quality of the food, and also dependent on the 



6b INTRODUCTION. 

state of the stomach. Pepper and spices generally augment 
the quantity of these acids. Superabundance of these is a pro- 
lific source of that morbid state of the digestive organs which 
constitutes dyspepsia. Suppose a patient, thus affected, takes 
some alkaline carbonate, as the bicarbonate of soda; chemical 
action instantly ensues in the stomach between the carbonate and 
the acids present. If acetic and muriatic acids be there, two 
salts will result, and carbonic acid gas will be thrown off by 
eructation. 

Some remedial substances are absorbed unchanged, and after- 
wards undergo decomposition while in the blood-vessels, or when 
they reach one of the secreting organs, and operate on the ner- 
vous system by one or more of their components. We are aware 
that no demonstration can be given to establish this view of the 
case. But there are certain results following the administration 
of remedies which admit of no other solution. Thus, we believe 
that mercury, in the form of protoxide, is absorbed and goes into 
the circulation undecomposed ; that, after its constitutional im- 
pression is apparent, it is actually decomposed. If a piece of 
gold be carried in the pocket of a person under mercurial influ- 
ence, it becomes obviously whitened, as though it had been rubbed 
with fluid mercury. It is also well established that fluid mercury 
has been found in bones, liver, and other parts of the human 
body. Similar phenomena have been noticed in connection with 
the protracted use of nitrate of silver ; the metallic silver having 
been found even in the pancreas, according to Mr. Brande. 

The action of these remedial agents, commonly called counter- 
irritants, or revulsives, demands a passing notice. Every one 
has observed the operation of this class of curative means, which 
probably had its origin in what we usually denominate a mere 
accident. An injury, more or less grave, has established a run- 
ning sore, and this has effectually cured an old cutaneous disease, 
simply by changing the seat of irritation, or by concentrating 
morbid action in a focus. It is recorded of a female who labored 
under incipient pulmonary consumption, that she was terribly 
burnt on the entire front of her chest. This casualty eventuated 
in her recovery. 

Keeping in view such indications as these, we seek to remove 
painful diseases by setting up a new action in a healthful part, 
and thereby transferring the old morbid action from its original 
seat and eventually eradicating it from the system. Thus we 
cure inflammations of the throat and fauces by irritants applied 
to the neck ; thus we relieve and cure inflammation of a mem- 
brane within the chest by exciting a temporary though severe 
inflammation on the surface. Nor is this kind of action confined 
to cases like those just named. We cure a distressing headache 



INTRODUCTION. 37 

by active purgation, which really involves the same therapeutic 
principle. 

The last mode of action of medicinal agents to be noticed is 
almost, if not altogether, chemical. Thus, when pure or caustic 
potash is applied to the skin, the vitality of the part is destroyed, 
and a new compound is formed with the animal matter. The 
fatty substance combines with the potash, and a saponaceous 
compound results. The action thus far is purely chemical, and 
lays the basis of a powerful counter-irritant operation. The action 
may be entirely chemical, as when magnesia is taken to correct 
gastric acidity. The acid of the stomach is made to disappear 
by reason of the combining power of the remedy. 

The general effects of medicinal agents on the vital solids and 
fluids, and on the animal functions, next claim our attention. 
In the use of the term vital or living solid, we mean to refer to 
the ultimate fibril of the organic tissues, — cellular, muscular, and 
nervous. We suppose that the change of condition *in an organ, 
as effected by a medicinal agent, is the result of impressions made 
by such agent on this fibril. This may not be very definite. But 
how can we get a better idea while our acquaintance with the 
ultimate structure of the solids remains imperfect ? We know 
that the heart's action is increased soon after alcohol enters the 
stomach. Here is positive increase in the motions of organized 
matter effected by an agent not absolutely contiguous. We can- 
not solve the phenomena except by supposing that the alcohol ex- 
erts an influence on the nervous fibrillse of the stomach, which 
causes more or less change in their condition and which is followed 
by corresponding change in the contractile fibres of the heart; 
or that alcohol enters the circulation, and reaches the tissues of 
the heart directly, ^producing the result independently of nervous 
communication. Now all this is based on mere hypothesis, so far 
as solution is concerned, for we cannot demonstrate the nature of 
the fibres spoken of, nor the changes they undergo. The conclu- 
sions we draw grow out of the well-known and uniform effects of 
a dose of alcohol. These are sense of warmth in the gastric and 
thoracic regions, increased action of the heart, and accelerated 
momentum of the blood, as inferred from the state of the pulse. 
Now, to every remedial agent acting thus, we give the name of 
stimulant ; while to all means whose use is followed by dimi- 
nished action, or reduction in the momentum of the blood, and a 
lowering of animal temperature, we give the name of sedative. 
And, as all remedial means act primarily on the living system so 
as to reduce or elevate, we infer that all may be included in these 
two classes, as respects their primary effect. That there are few 
direct sedatives, is conceded ; yet none will say that venesection 
may not prove directly sedative, nor that cold may not act in the 



38 INTRODUCTION. 

same way. Very many articles operate as indirect sedatives ; in 
other words, the first impression of an active stimulant having 
subsided, a state of indirect debility follows, and this is called a 
sedative effect. In this way, opium and alcohol may be indirect 
sedatives, although they are, in the first instance, direct stimu- 
lants. But in either case, we are warranted in the belief that 
coincident with the medicinal effect is a change of some sort or 
other in the living solid. 

The action of remedies on the living solid is often much influ- 
enced by a state of disease. Thus, a person unaccustomed to 
the use of brandy in health may swallow a pint or more in a clay, 
in the form of milk punch, in a state of prostration, induced by 
excessive purgation, and not feel the stimulus in the smallest 
degree, excepting as a restorative both to the bowels and to the 
general system. Less than half as much brandy, at another time,* 
would completely inebriate the same individual. And, further, 
the stomach, in health, will receive and tolerate a hundred articles 
which could not be tolerated if gastritis were present. Disease 
induces an augmentation of local sensibility, by reason of which 
medicines seem to act with unwonted power ; while, at other times, 
it appears to reduce the sensibility so as to blunt and render null 
the energy of remedial appliances. The latter is illustrated in 
the failure of opium to impress the stomach of an old drunkard 
laboring under delirium tremens ; and the former in the prompt- 
ness with which the same remedy acts on the same person after 
the free use of emetics has roused the gastric sensibility to a 
point above the natural standard. In the one case, twenty grains 
may sometimes prove inert ; in the other, a single grain may lock 
up the system for hours in a most salutary sleep. Who, for a 
moment, can believe that, in all these opposite results, the living 
solid is unchanged, and passive as the block of marble under the 
mason's chisel ! 

The effects of remedies on the living fluids are more important, 
perhaps, than the action of the same on the living solids. The 
blood is, unquestionably, the most important of the animal fluids ; 
and it is so, mainly, because all the other fluids are formed out of 
it. Varieties in these, at different times, are traceable to as fre- 
quent variety in the blood itself. This fluid, being formed out of 
chyle, whose quality must needs vary more or less with the food 
whence it is formed, must be liable to great and frequent changes. 
We do not pretend to affirm that the essential character of the 

* The author realized this fully in his own person, in the year 1846, at Car- 
rolton, on the mouth of the Kentucky river, where he was detained with a most 
exhausting attack of cholerine, for which he swallowed, in a brief space, as 
much brandy as would have inebriated him, perhaps a whole week, in full 
health. He never drinks brandy, nor any of its associates, when well. 



INTRODUCTION. 39 

blood can be destroyed in a living system while the powers of 
vitality are fully at work ; yet we have no doubt that changes or 
modifications may occur which at one time may give rise to dis- 
ease and at another exert a most salutary tendency. 

The remarks just made in respect to the blood are applicable 
to the secretions and excretions. Every one is aware of the pe- 
culiar odor of the urine after partaking of asparagus ; and Dr. 
Franklin's mode of preventing that odor, by swallowing a few 
grains of white turpentine, is also familiar. All this is explica- 
ble on the influence imparted to the circulating blood, and con- 
veyed to the kidneys, unless we solve the whole by reference to 
the acknowledged sway of the nervous energy. That alterations 
in the sensible properties and actual constitution of the secreted 
fluids may depend on, or be influenced by, some new action in the 
organs themselves, is quite probable. But how can it be known 
that this supposed new action is not the result of some previous 
action on the mass of blood ? All this, to be sure, is conjecture ; 
but we are at liberty to weigh probabilities, and thence make the 
best inference we can, in the absence of clearly demonstrative 
proofs. 

The animal functions feel, very sensibly, the influence of me- 
dicinal agents ; and as this is a subject of much practical import- 
ance, we will devote a few moments to its consideration. 

The connection between the tissue of an organ and the func- 
tions of that organ is obvious. If the tissues on which medicinal 
agents operate be in a state of comparative disease, the function 
will be more or less interrupted or impaired. If any unusual 
impression be made on the nervous tissue of an organ, the result 
will almost invariably be a modification of the function, and this 
is what might naturally be anticipated. This result is common to 
all the organs, whether they relate to the motions of the body or 
the faculties of the mind ; and a careful attention to the changes 
or modifications effected by medicinal agents affords the chief 
means of ascertaining the proper therapeutical action and value 
of remedies. We should be careful not to confound modification 
of function resulting from medicinal action with those that flow 
from natural causes alone. Hence, too, the need of distinguish- 
ing temporary modification of function, which may happen inde- 
pendently of mechanical agency, during the administration of 
remedies. For it is well known that palpitation of the heart, 
cough, and convulsion, may cease soon after a medicine is ad- 
ministered, and yet these salutary changes may not depend on the 
article given, in the least degree. Hence the frequent erroneous 
inferences made by physicians, leading to the assumption of credit 
for skill and tact where none was due. 

We know, further, that medicinal agents exert a decided in- 



40 INTRODUCTION. 

fluence on the vital functions, and thence effect changes in the 
condition of the diseased organs, — a fact the proof of which rests 
on careful observation, showing that the same effect is always ob- 
served to follow the administration of the same medicine. Such 
is at least the general rule. Let the following illustration suffice. 
The liver is found to be defective in its secreting function, and 
we prescribe the blue pill. This passes into the circulation, ex- 
citing the whole glandular and capillary system, stimulating the 
languid pori biliarii, which are said to secrete the bile from the 
blood of the extreme branches of the vena portarum, thus renew- 
ing the secretory function and giving it a more healthful quality. 
The remedy, being continued a little longer, stimulates the orifices 
of the common duct, the liver and pancreas, so that the bile and 
pancreatic juice flow freely, and the process of chylification is 
restored to its normal state. The general nutrition of the system 
is soon manifestly improved, the stomach and other organs are 
invigorated, while the flow of bile into the intestines restores their 
regular peristaltic motion and consequent evacuation. Now these 
results occur with such uniformity as to warrant the inference 
that has been already named. 

It is important to keep in mind the difference between the phy- 
siological and therapeutic action of a remedy. Thus tartar 
emetic acts physiologically when it evacuates the contents of the 
stomach ; but the therapeutic effect may reach to the head, in the 
relief or cure of headache. The physiological action of a 
cathartic is to excite the peristaltic motion of the intestines and 
cause due evacuations ; but the therapeutic action may be the 
improvement of the digestive functions,- or the relief of the eyes 
or head, or whole system. The physiological action is dependent 
on the almost immutable and constant influence of a given medi- 
cine on the organic tissues, and is liable to little diversity. The 
therapeutic effect is modified by peculiar conditions of the body, 
and by the circumstances attending the disease, to subdue which 
the remedy is directed. It sometimes happens that the full phy- 
siological effect is not obtained, even after a full dose has been 
given ; yet there is always an approximation thereto. Thus, if 
a full dose of ipecacuanha should fail to vomit, it will almost 
always nauseate, and thus prove that it has made an impression 
on the organ. Hence, if a physician be correct in his pathological 
view of a case, he may make a pretty correct calculation as to 
the therapeutic effect, from the greater or less energy of the medi- 
cinal agent on the organic tissue. 

From what has been said of the modus operandi of medicines, 
the following inferences may be deduced : 1st. That the cure of 
disease by remedial agency does not depend on any specific in- 
fluence, and that the terms in common use, as antiphlogistic, feb- 



INTRODUCTION. 41 

rifuge, &c, are only conventional, or the result of common con- 
sent, and merely serve to announce a secondary result, flowing 
from the appropriate action of medicinal agents on the vital solids 
and fluids. 2d. That remedies may influence the general habit 
by an immediate impression on the stomach and alimentary canal, 
either in their entire form or in a state of decomposition. 3d. 
That medicines may affect the general constitution of the fluids 
by entering the circulation ; and these changes are not necessarily 
dependent on any kind of chemical influence. 4th. That medi- 
cines taken into the circulation and carried to remote parts, either 
entire or decomposed, may there exert their peculiar energies. 
In doing this, there would seem to be, although we repudiate the 
doctrine of specifics, a kind of elective affinity or selection, so as 
to direct the physician to employ one article for evacuating the 
bowels, another for exciting a copious perspiration, and the like. 
"With here and there an exception, growing out of circumstances 
not easily explained, these effects follow the medicinal administra- 
tion with so much regularity that wc hesitate not to say not only 
ivhat the effect will be, but when it will be. 

Doubtless we have yet very much to learn in respect of the 
various circumstances that modify the operation of remedial 
agents. We know, certainly, that many conditions favor and 
produce this modification. Thus, peculiar conformation of body, 
difference of sex, of climate, of temperature, of diet, of habit, 
&c, as these relate to individuals ; the customs, superstitions, and 
political relations of society, the state of the mind, the temper, 
the intellectual powers, all may exert a modifying influence. 

No one doubts that what we commonly call " a man's constitu- 
tion" is very much under the influence of peculiar bodily conform- 
ation. What is fully and precisely meant by this phraseology 
we cannot easily determine so as to convey definite ideas. In 
fact, it is not practicable to do so, always, if ever, from the nature 
of the case. Yet facts may help to illustrate our meaning. Thus, 
Julius Caesar was uniformly seized with epilepsy on the eve of a 
great battle, although his courage was above suspicion. Not one 
in the army, save the leader, was thus affected. We say, there- 
fore, that Caesar had a peculiar constitution, resulting from some 
unusual, though unperceived, bodily conformation. His nervous 
system was, beyond doubt, susceptible of intense excitement from 
special causes. That Lord Bacon fell into a state of syncope at 
the moment the moon had passed its full, is assignable to the 
same principle. It is reported of a lady who had ceased to nurse 
for a long time, that, on hearing a child cry, a copious secretion 
of milk filled her breasts. 

It is a truth too often observed to be doubted, that no state of 
the bodily frame so powerfully modifies the operation of medicines 

4 



42 INTKODUCTION. 

as that which renders the nerves exquisitely susceptible of im- 
pressions. This condition may be the consequence of original 
conformation, or it may be the product of disease. It is on the 
same principle, that the mind is said to control so absolutely 
the action of many remedies. Cases in point will occur to the 
recollection of every reader. Let the following serve for illus- 
tration : — A lady was laboring under an affection of the bowels, 
attended with severe pain and obstinate costiveness. She was 
bled, put into a warm bath, freely plied with cathartics, anodynes, 
&c, without relief. The case was perplexing, but the physician 
soon learned that the patient labored under a Settled conviction 
that she could not be relieved by any other than her old physician, 
who resided many miles off. As he was supposed to understand 
her constitution better than any one else, the friends determined 
to gratify her. The old doctor was called in, and although he 
did not change the treatment at all, the bowels were soon freely 
moved ; sweet sleep followed, and in a few days the patient was 
well. It is not pretended, however, that the same result would 
not have followed if the old doctor had not been obtained. Tem- 
peraments and idiosyncrasies have a great deal to do with what 
we call the constitution. Nor can it be doubted that the original 
variety of these, as well as subsequent modifications, have much 
to do with peculiarity of bodily conformation. All the tempera- 
ments have their peculiar and special distinctive features, and are 
identified with certain external marks or expressions of counte- 
nance, organs, &c. What it is in the living fluids or solids that 
constitutes these diversities is undetermined ; and yet it cannot 
be questioned that there are real grounds of diversity. 

Idiosyncrasy, although it cannot be ascertained by an inspec- 
tion of exterior signs, as temperaments may be, is pretty certainly 
recognized by a very attentive examination of the constitution, 
and in no other way. The derivation of the word simply indicates 
a peculiar composition ; but this does not fully reach the merits 
of the case. And in order to become conversant with the idio- 
syncrasy of a patient, the physician must be constantly on the 
watch, to seize on every peculiar development that may arise in 
the course of medicinal administration. Individuals who evince 
idiosyncrasy in regard to sounds, or tastes, or smells, in a state 
of health, are apt to manifest something of the same nature in 
reference to the use of medicines. 

Something like idiosyncrasy is occasionally manifested in the 
pulsation of the heart and arteries. Bonaparte's pulse, it is said, 
never exceeded forty-four in the fullest health. Heberden gives 
the case of a woman, aged fifty, whose pulse was always inter- 
mitting, and this, too, independently of peculiarity of structure, 
as dissection finally proved. 



INTRODUCTION. 43 

What constitutes idiosyncrasy, what is its basis, where its loca- 
tion ? Can we analyze it ? That it depends on some peculiarity 
of the nervous system is, perhaps, certain ; yet we cannot prove 
it to be so. Nor is it important to be able to define its origin or 
nature ; and yet it is very needful to ascertain not only its ex- 
istence, but its peculiarities, in the same person, and in different 
individuals. Some patients are seized with a fit of asthma the 
moment a particle of ipecacuanha is brought in contact with their 
persons. This is not conceit, nor hypocrisy, but a veritable reality, 
which we call idiosyncrasy. The lesson taught here is never to 
prescribe ipecacuanha to a patient of this description. The same 
principle of action extends to other remedial agents, and to various 
articles of food. Some persons cannot eat cucumbers, nor even 
sit at a table where they are served ; and the same is true of cer- 
tain kinds of cheese. Much could be said of the influence of age 
and sex in controlling the action of medicines ; and the considera- 
tions are of great value. But they are so obvious to all, that it 
is not necessary to enter into details. The power of custom or 
habit is much more extensive and influential, and to it we shall 
devote a few remarks. 

The ability acquired by custom or habit to endure extremes of 
cold and heat, is familiar to all classes of society. In fact, there 
is scarcely a condition, however unnatural, that may not be made 
endurable, on the same principle. In virtue of it, the Siamese, 
as we are told, become fond of rotten eggs, and digest them 
readily, and without any sort of disadvantage. The fetid gum 
obeys the same law, and though at first detested, can at length 
be carried in the pocket, as if it were an article of confectionery. 
In the same way we account for the influence acquired over most 
of the functions of the animal economy. 

The power of custom or habit over the operation of medicinal 
substances is of great value in a practical point of view; and 
hence claims special attention. Hence it is that the same kind 
of medicine, exhibited daily in the same dose, soon fails to dis- 
play its wonted energy. Precisely thus is it with intoxicating 
drinks. He who takes his half-gill of brandy every day for two 
weeks will, at the end of that time, call for more. The dose must 
be augmented, or the desired impression will fail. Yet the original 
properties of medicine and of the brandy are unaltered, and the 
condition of the parts with which they come in contact may be 
very little changed. Many persons, by the use or abuse of opium 
in gradually-increased doses, reach a point when it is almost in- 
capable of affecting them in any quantity. 

It is on the very same principle that some persons become 
proof against offensive odors. The operatives in bleaching fac- 
tories are often benefited by a chlorinated atmosphere, in which 



44 INTRODUCTION. 

the proprietors cannot remain comfortably for the space of five 
minutes. Baron Haller was never so much at home, nor so 
little annoyed, as when engaged in the dissection of dead bodies ; 
yet the fetid perspiration from the feet of a visitor put his good 
humor to the test more than once. I knew an old female who 
had followed the occupation of laying out the dead for more than 
thirty years, who declared that no sensation was more agreeable 
to her than that of handling a corpse. These, and similar facts, 
assure us of the vast power of habit or custom to modify and 
even control the action of medicines ; we are taught thereby the 
necessity of ascertaining the habits of patients before we pre- 
scribe an article from which we anticipate important results. If 
the physician is called to a man laboring under disease attended 
with severe pain and constant wakefulness, who is in the habit of 
using opium freely, this latter fact must be ferreted out. It would 
be almost, perhaps quite, impossible to benefit him by the same 
medicine in any practicable close ; and yet it might not be difficult 
to relieve him by substituting some other narcotic in its place. 

Climate has also a share in the modification of medicinal action 
and energy. No doubt a part of the influence ascribed to climate 
belongs to custom or habit. The slender and delicate Hindoo, 
who lives entirely on vegetable food, is not acted on by medicine 
as is the Esquimaux, who gorges himself with the flesh of the seal 
and the blubber of the whale. Climate may have something to 
do with all this ; yet we cannot but believe that custom contributes 
to the result. 

Still, we cannot doubt the power of climate to modify the action 
of medicine, as well as the essential nature of remedial agents. 
Englishmen and Irishmen who settled in the vicinity of Philadel- 
phia forty-five years ago, when intermittents and remittents were 
almost universally prevalent, could not be purged with the same 
doses that acted promptly on old citizens. Dr. Reynolds, in a 
paper published many years ago in one of our medical journals, 
declared that he could not cure an Irishman of ague and fever, 
who had lately arrived and located in what is called "The Neck," 
without employing three or four .times as much Peruvian bark as 
sufficed in the cases of Americans long settled in the neighbor- 
hood. 

Then, too, climate often affects the quality of the remedy. 
This is true of colchicum, digitalis, conium, and other articles, which 
nearly lose their peculiar properties in certain localities. Hence 
we are told that small doses of narcotics act with more power in 
Naples than larger ones do in England. And we may learn, too, 
from such facts, why immense doses of narcotics have so often 
failed to do serious harm. 

The operation of medicines is variously affected by the mind, 



INTRODUCTION. 45 

and this can be ascertained apart from any attempt to investigate 
the nature of mind. When we talk of mind in this relation, we 
mean just what is generally understood by the term. Every one 
has witnessed, more or less, the mutual influence of mind and 
body. The facetious author of "Tristram Shandy" has forcibly 
expressed the idea, in his comparison of soul and body to a coat 
and its lining. "If you rumple the one," says he, " you must 
certainly rumple the other." 

What are sometimes called the passions, in contradistinction 
from the emotions of the mind, are held to operate differently, 
the former being regarded as sedatives, the latter as stimulants. 
The depressing agency of the passions is often observed in men 
who are sorely harassed in their business operations. The sto- 
mach often feels the disturbance, in the deterioration of the gas- 
tric juice ; the digestive powers flag, and presently dyspepsia or 
indigestion is complained of. In some persons, the depressing 
agency fastens on the bowels, and the man is annoyed with disa- 
greeable intestinal irritation. Sorrow, fear, terror, all tend to 
like results. 

On the other hand, joy is confessedly a stimulus, and frequently 
a very powerful one. The whole system often realizes its influ- 
ence for good. When excessive, however, it may operate preju- 
dicially, as other stimulants often do. Occasionally, a sudden 
outburst of joy has destroyed life almost instantly. Sophocles 
died the moment he was crowned for composing a tragedy. Dr. 
Mead testifies that more men went mad, in the time of the South 
Sea bubble, in consequence of making vast fortunes, than from 
being ruined by the speculation. 

Notwithstanding these and other fatal consequences growing- 
out of excessive joy, it is most certain that when its stimulus is 
brought to bear on the human economy in moderation, and appro- 
priately in all respects, it acts as a very desirable, gently-exhila- 
rating cordial. As such the physician is bound to use it in 
furthering the usual efforts of his noble art. 

Confidence is eminently important in the administration of 
remedies, and is frequently an essential element in professional 
success. The effect of confidence between patient and physician 
has often exerted a most happy reciprocal influence. The patient, 
placing implicit reliance on the skill of his physician, takes his 
prescriptions with unwavering faith in their efficacy. The physi- 
cian, assured that such is the state of his patient's mind, feels 
that the disease he is contending with is shorn of half its danger. 
And if all this be so, how pernicious must be a lack of confidence 
between parties such as these ? 

The " medicine man" of the North American Indians, whose 
exploits are so graphically delineated by Mr. Parker in his jour- 



46 INTRODUCTION. 

nal, published a few years ago, effected nearly all he hoped to 
accomplish by availing himself of the confidence of his patients. 
And the astonishing success of bread pills in the cure of diseases 
held to be almost beyond the reach of art, is accounted for on 
the same principle. This, too, lies at the foundation of nine- 
tenths of all the wonderful exploits of mesmerism, homoeopathy, 
and hydropathy. I know a most respectable and influential 
minister of the Gospel, who, though a very intelligent and well- 
informed man, was a warm advocate of the powers of the infini- 
tesimal system of practice. It so happened that he was taken, 
as he believed, very ill, soon after retiring to bed, and, as he 
feared, without a particle of his favorite medicine in the house. 
Some domestic remedy was administered, but with no good effect. 
His wife, who understood her good man's constitution very well, 
and who had no love for homoeopathy, told her husband that she 
would make diligent search for some of those little invisibles of 
which the parson was so fond. -She set about forthwith to pre- 
pare the wished-for medicine, using in the process a little sugar 
and flour and so forth. The resemblance to the genuine article 
was capital; and presently the overjoyed wife returned to the 
sick chamber with the treasure. The confiding husband, not 
doubting that he was once more about to enjoy the delight of his 
heart, swallowed the portion with avidity, and presently fell into 
a sound sleep which was not interrupted until the clear light of 
morning burst on his vision. " Why, wife," said he, "I never 
had such a delicious night's rest in my life. I love homoeopathy 
more than ever." 

Some forty-five or fifty years since, a man who was known as 
the Dutch Root Doctor was the lion of the day in Philadelphia 
and the region round about. He poured all his medicine, for all 
sorts of patients, out of the same huge vessel, but excited interest 
and confidence by making numerous inquiries, noting down the 
name, sex, age, and disease of each patient, and labeling the 
bottle furnished to each accordingly. A clergyman of high dis- 
tinction, and so liberally educated as to be professor of belles 
lettres, dismissed one of our most learned and respectable phy- 
sicians, who had been treating a daughter for pulmonary consump- 
tion, and put her under the care (if that term be not a misnomer) 
of the Dutch Root Doctor. It need not be told that the scene 
soon closed. There was confidence enough at work in this in- 
stance, but it was in the ivrong place, and altogether out of place. 

The last controlling influence to be named in connection with 
the operation of medicines, is the variable condition of the body 
in the progress of disease. My meaning will be sufficiently ex- 
plained presently. It is easy to conceive that a variety of circum- 
stances, in the progress of disease, may conspire to render a me- 



INTRODUCTION. 47 

clicine of but little advantage at one time that is obviously useful 
at another period. Thus it was remarked long ago by Sydenham, 
that, although an active cathartic may do good before an ague and 
fever is checked by tonics, yet if it be administered directly or 
soon afterwards, the ague will, in all probability, be reproduced. 
The reason of all this is abundantly clear. 

A blister may be very proper to arrest febrile action ; but if it 
be applied when the system is much above or much below the 
blistering point, it does positive mischief, or fails entirely to ex- 
cite action in the cutaneous vessels. If bleeding or purging be 
interposed, the blister will produce the desired effects. So, also, 
of the use of opium in dysentery. It is a good or bad medicine 
according to circumstances. If proper depletion be first resorted 
to, and the bowels freely opened, an opiate will act well. If these 
preliminaries be neglected, an opiate will do mischief, excepting in 
the advanced periods of the disease. The governing maxim in 
this, and in all other diseases, should be to treat the case not in 
reference to the name of the disease, but according to the existing 
state of the system as developed by the pulse, skin, tongue, 
countenance, the excretions, &c. &c. For want of attention to 
this cardinal principle in medicine, our books are filled with con- 
tradictory statements touching the efficacy of almost every im- 
portant article of Materia Medica. While physicians all over the 
country have their panaceas and stereotyped prescriptions, we 
know of none. It is a settled principle with us, that every case 
of disease has to be treated according to its own character, and 
that a remedy or plan which might suit very well now would not 
be proper six months hence in a disease called by the same name 
and regarded by many as exactly the same. As the nature of 
diseases is a subject of constant change in many respects, we are 
precluded from the adoption of any uniform plan of treatment. 
We are, therefore, vastly more dependent on sound judgments 
than on retentive memories in the successful discharge of profes- 
sional duty. Yet how many practitioners are there who seem to 
have no more use for judgment than if they were born with the 
entire lack of this important element in the mental constitu- 
tion ! They appear to regard the human system as a mere ma- 
chine, moved only by external appliances, independently of the 
vital forces that modify and control all its actions. This subject 
has interest enough to justify a copious volume dedicated to its 
exclusive consideration. 

The reader may have anticipated a full history of the princi- 
ples of homoeopathy, as related to the modus operandi of reme- 
dies. It is our purpose, however, to notice the subject with all 
possible brevity. There is so much of the inexpressibly ridiculous 
in the peculiar vagaries of Hahnemann that it would be a waste 



48 INTRODUCTION. 

of time to enter into details. Hippocrates had adopted the posi- 
tion that contrary diseases are cured by contrary remedies ; and 
as the German innovator felt himself called upon to direct his 
efforts at the great source of medical truth, he chose for his motto 
the direct opposite, viz., that similar diseases are cured by simi- 
lar remedies. Another peculiarity of this dreamy system is the 
pathogenetic ', or disease-producing power of medicines, in virtue 
of which it is assumed that a medicine, in order to be able to cure 
a disease, must have the power, in augmented doses, of causing 
precisely the same disease. Thus it is asserted by Hahnemann 
that he induced fever and ague in his own person by taking large 
doses of Peruvian bark ; " and we all know," says he, " that bark 
given in small portions is the grand remedy for intermittents." 
In like manner, he avers that the common itch may be set up by 
very large quantities of sulphur, while in moderate quantity it will 
infallibly cure the itch. And, surely, all this looked very much 
like a fair and honest statement. But the celebrated Andral re- 
solved to test the position thus supposed to be established ; and 
he therefore performed a series of experiments which resulted in 
the total disproof of Hahnemann's plausible statements.* 

The practice of this deluded man has been called infinitesimal, 
because it is fairly inferable, from all he has said, that doses di- 
vided and diminished ad infinitum are thereby augmented in 
efficiency. What else can be deduced from fluid mixtures holding 
in solution a hundred-millionth part of a grain in every sixty 
drops ; or from the boasted value of the millionth of a grain of 
common salt ; or from the devotion of thirty-five printed pages to 
show the mighty efficacy of the millionth part of a grain of char- 
coal ? The almost infinite increase of power, resulting from un- 
limited trituration and dilution, is a feature of the system equally 
ridiculous, and yet it is insisted on with unyielding tenacity. 

* The disciples of Hahnemann occasionally prove false to their cherished in- 
fmitesimality, and feel constrained by the force of circumstances to concede the 
folly of the system. A few years since, the wife of a clergyman in this city 
was under the care of the Magnus Apollo of the small-dose practitioners. The 
case was of long standing, and, no doubt, the patience as well as medical re- 
sources of the doctor underwent a severe trial. A few weeks prior to the lady's 
decease, her husband, looking sideways at the paper on which his physician was 
writing something as the result of long study in the easy arm-chair, discovered 
one or two noted articles of the so-called allopathic school. Taken by surprise 
at this strange procedure, he paused in his walk to and fro, exclaiming, "Why, 
Doctor, are you not prescribing articles belonging to the old school of physic ?" 
To which it was responded that he had actually exhausted all his own stock, and 
felt disposed to try a little allopathy. "Oh, sir, if that be the case," said the par- 
son, "I prefer to select my own physician, and therefore you may withdraw. 
I sent for you as first in homoeopathy, but now I shall call for the first in allo- 
pathy." This fact is undeniable. Besides, there are scores of individuals in 
Philadelphia who by turns, as the whim moves them, vibrate from homoeopathy 
to allopathy, not once, but often. 



INTRODUCTION. 49 

Were the position true, that the strength of a fluid mixture was 
augmented by dilution, then, beyond all doubt, an ounce of lauda- 
num poured into the head of the Allegheny should narcotize every 
individual who drank of the water of the Ohio, down to where it 
empties into the Mississippi; and the fish, too, of that noble 
stream, could not fail to be destroyed by the poison. 

But while we condemn, as we do, the childish nonsense of the 
almost invisible doses of Hahnemann, we are free to censure with 
unsparing denunciation the opposite extreme, as we and others 
have witnessed it in the South and West. And preposterous as 
have been the delusions of the infinitesimal system, it merits a 
passing commendation for the good it has accomplished, in wholly 
abolishing, or greatly abating, what has been termed the mam- 
moth-dose practice. The tablespoonful doses of calomel, we 
fondly believe, have been administered for the last time ; and we 
doubt not that he who would speak of them fifty years hence would 
forfeit, in some measure, his standing as a man of truth. 

In the compounding of medicines the apothecaries' weight is 
generally employed in this country. We give the usual tokens 
for a pound and its diminutives. 

1 pound, or ft)i, or 12 ounces, or 5760 grains. 

1 ounce, or ^i, or 8 drachms, or 480 " 

1 drachm, or zi, or 3 scruples, or 60 " 

1 scruple, or ri i, or . . .20 " 

J scruple, or t)ss, or . . .10 " 

The following are among the more important abbreviations 
commonly employed in writing prescriptions : — 

Ci, or cong. i, or congius 1, or 1 gallon, contains 8 pints. 

Oi, or oct. i, or octarius 1, or 1 pint, " 16 fluidounces. 

^i, or oz. i, one ounce, " 8 fluidrachms. 

^ifl., or one fluidrachm, " 60 drops. 

Gr. i, denotes one grain. 

Grs. ij, denotes two grains. 

M frequently stands for drop. 

Minim " " 

Gtte., goutte, gouttes, drop, drops. 

Cochleare magnum, a tablespoonful. 

" minimum, a teaspoonful. 

" medium, a dessertspoonful. 

Possibly some of my readers may be disposed to say that this 
book should have been called a Dispensatory. But, having the 
christening in my own hands, it has seemed good to me to give it 
the title it bears, and, as I think, most appropriately. If a Dis- 
pensatory be not a work on Materia Medica, why is it made a text- 
book by professors, who teach this department of medical science ? 



50 INTRODUCTION. 

The fact is too palpable to be misunderstood by men of sound 
common sense, that a good Dispensatory cannot be a bad exhibit 
of Materia Medica ; and it is equally manifest, that a well-digested 
work on Materia Medica and Therapeutics, even though alpha- 
betically arranged, cannot be a serious hinderance to the study of 
the teachings of a Dispensatory. Vastly fond am I of judicious 
and real distinctions ; but I confess that I have no special regard 
for a distinction that hardly implies a difference. 



MATERIA MEDICA AND THERAPEUTICS. 



In conformity with the plan marked out in the Introduction, I 
am to speak of the various means resorted to for the prevention, 
palliation, and cure of disease, — saying as little as may be desi- 
rable touching their botanical, natural, and chemical history, but 
dwelling on their therapeutical and toxicological relations so fully 
as not to exhaust the patience of the reader and yet to win his 
interest in the subject. And, as this is to be done in the order of 
an alphabetical arrangement, it will be expected that I shall con- 
form to custom, and name first in the series the well-known source 
of the familiar article called Burgundy pitch, viz., the Abies 
Excelsa, a species of pine. It is clearly of no importance to 
dwell on the peculiarities of this tree, because our business is with 
the pitch, and not with the vegetable source of it. Nor is it 
needful to consume time with any special description of the pro- 
duct named, since everybody is familiar with it. 

My chief reason for noticing it here refers to its very extensive 
use during the prevalence of Asiatic cholera in the West. That 
disease may revisit this country, and hence the importance of 
attending to the prominent traits of domestic as well as of scientific 
practice that obtained during its prevalence. 

How the use of pitch plasters originated I know not ; but it is 
certain that many thousands were manufactured in various sec- 
tions of the country, and worn as a preventive of the dreaded 
malady. No doubt the application of them to the epigastric 
region was based on the general belief that the disease commenced 
in the stomach, and that by irritating the skin over that organ 
the evil would be averted. Nor will I say that such may not 
have been the effect of the plaster in some cases ; yet I felt con- 
fident that the remedy not unfrequently accelerated the morbid 
development. In persons of high nervous irritability, the irritant 
action of the pitch on the skin served only to augment the ner- 
vous disquiet of the patient, and thus tended to give rise to the 



52 WORMWOOD — GUM ARABIC. 

diseased action which the application was designed to prevent. 
Cases of this kind came under my notice in 1832 ; and, therefore, 
as soon as I could learn that a man of the above temperament 
had a plaster over his stomach, and found him exceedingly anxious 
and fidgety, my advice was promptly given for its removal, and 
with good effect. 

The Burgundy pitch plaster is often of service to females who 
complain frequently of weakness and some pain in the lumbar re- 
gion. It gently stimulates the surface, excites a pleasant glow, 
and gives a mechanical support to the parts. It may be made 
more irritant by mixing with the melted pitch a small quantity of 
powdered Spanish flies, and thoroughly incorporating them. 
Half a drachm of the flies to an ounce of pitch will make a pro- 
per mixture. 

Many of the plasters made in 1832 were spoiled in the hasty 
efforts to prepare enough to meet the demand. The pitch was 
actually decomposed, and its adhesive and other properties thus 
destroyed by the intensity of the heat employed. Care should 
be taken to heat the ladle or pot in which the pitch is to be 
melted no further than to cause its complete fluidity, and this can 
be effected without altering its color essentially. It should be 
poured out on soft sheep-skin, or Russia sheeting, or thick paper, 
and instantly spread over the surface uniformly with a gently- 
heated spatula. 

Absynthium. Wormwood. — The tops and leaves of the Ar- 
temisia absinthium. This plant is named here because it can 
be had in almost every part of the country, and is therefore 
cheap and well suited to many persons. It is a good tonic, and 
is esteemed by many as an anthelmintic. It may be given in 
cold or hot infusion, or decoction, or powder of the dried leaves, 
or in the shape of extract. The green leaves, gathered when 
the plant is mature, should be dried in a well-aired loft, and not 
by exposure to the sun. In the latter case its volatile oil is dis- 
sipated. 

Acacije Gummi. Cfum Acacia. Gfum Arabic. — This is a 
spontaneous exudation from the bark of the Acacia vera of 
Africa, the gum of the Mimosa nilotica, and the Sant of the 
Egyptians. It is a low tree, of a hard, withered aspect, the stem 
being covered with a gray bark. As the gum exudes, it is semi- 
fluid, hardens by exposure, and does not lose thereby its trans-, 
parency. As we get the article, it is inodorous ; but when first 
collected it has a faint, peculiar smell. It is stated as a singular 
fact that the bark of the tree yielding this gum is quite astrin- 
gent. On this account it has been employed in India in the pro- 
cess of tanning. The cherry and the plum tree barks, that yield 
a gum almost tasteless, are also astringent. 



GUM ARABIC. 53 

The best quality of gum Arabic has a very pale straw color, 
breaks with a vitreous fracture, is transparent, inodorous, insipid, 
and feels quite viscid in the mouth. It is generally received in 
this country in small, round, irregular lumps, of easy fracture. 
Analysis shows it to contain bi-malate and muriate of lime, mu- 
riate and acetate of potash, and some other matters. 

Dealers in gum Arabic are familiar with two sorts that are 
often found in the same bale, and it is important that all pur- 
chasers, and especially physicians, should know something in this 
relation. The genuine gum has the properties already specified, 
while the gum Senegal, so often in its company, is a dark-colored, 
yellowish-brown substance, with a rough or corrugated surface. 
The lumps of this variety are much larger and more globular than 
those of the pure gum, and very hard to break and pulverize. 
The pure gum is much more easy of solution in water than the 
Senegal ; it is also soluble in solutions of the pure alkalies, in lime- 
water, and the vegetable acids. It is insoluble in alcohol, ether, 
and oils. A few drops of solution of protonitrate of mercury 
added to a solution of pure gum, give a beautiful peach-blossom 
color. A solution of gam Senegal treated in the same way, is 
changed to a bright red that becomes turbid in a few hours. 

It is said, also, that if pure gum Arabic be rubbed with tinc- 
ture of guaiacum, a blue color is evolved, changing gradually to a 
pale green, and finally to a deep blue. This is held to be the best 
test of the difference between gum and mucus. Alcohol added 
to a solution of gum Arabic causes a flocculent precipitate, but 
it coagulates mucus. 

A concentrated aqueous solution of gum Arabic may be kept 
a long while, unless the weather be very hot, in which event it 
will ferment. A weak solution ferments speedily, and acetous 
acid is developed. Nitric acid changes pure gum into mucus or 
saccho-lactic acid. 

The specific gravity of gum Arabic is 1.4. It is composed of 
oxygen, carbon, hydrogen, and nitrogen, so that it may be called, 
really and truly, a nitrogenized substance. The nutritive pro- 
perties of the gum are well known, however much some theoreti- 
cal men may have talked to the contrary. The poor natives of 
Hindostan consume it largely as an article of diet. I have known 
patients to subsist on it for months, and without any obvious loss 
of bulk or health. Some writers have actually denied that the 
gum can thus be employed, affirming that its bad effects on the 
tone of the stomach are soon developed. But in Haselquist's 
Voyages the story is told of a caravan of Abyssinians who would 
have starved but for the discovery of a stock of gum Arabic 
among their merchandise. On this a thousand persons subsisted 
for two months, and with no injurious results. In times of great 



54 GUM ARABIC. 

scarcity of food of the more ordinary kind, whole towns have 
been sustained by it. It is quite true that dogs soon perish if 
fed on gum exclusively ; but it must be borne in mind that they 
are carnivorous, while man is an omnivorous animal. 

Gum Arabic is properly classed with Demulcents, because of 
its softening, sheathing, soothing qualities. Dioscorides speaks 
of it as blunting the acrimony of various remedial agents, and we 
all know its power to sheathe the mucous coat of the stomach 
from the action of poisons. The demulcent property is further 
seen in its use in gonorrhoea, dysentery, strangury, catarrhs, and 
in tenesmus from any cause. The thicker the solution is the 
more obvious is its demulcent quality. 

The solution of gum Arabic is often very useful as an enema 
in the diarrhoea of infants ; but the irritability of the rectum is 
sometimes so great as to require the addition of a few drops of 
laudanum. As a general rule there is too little gum Arabic added 
to chalk juleps, which are so frequently administered in diarrhoea 
dependent on relaxation and debility. In place of two drachms 
to six ounces of fluid, a half-ounce may be usefully added. This 
quantity will more certainly insure a perfect mixture, and more 
effectually blunt acrimony, and so protect the mucous membrane 
of the bowels from greater derangement. 

The most recent application of the solution of gum Arabic is 
to hums and scalds. The solution is applied by means of a soft 
brush over the whole surface, and this is repeated until a complete 
coating is secured. I have no doubt it will prove a good expedient, 
and should be tried whenever the article is at hand, just at the 
moment when such an accident occurs. It seems to me that its 
action is not unlike that of Collodion, which article the reader 
can consult. (See Edinb. Med, and Surg. Journal, Oct. 1842.) 

In compounding oleaginous prescriptions, and occasionally those 
of a resinous quality, we can hardly dispense with gum Arabic. 
It is just such a bond of union as opposite articles like oil and 
water seem to call for. We commonly resort either to the powder 
or mucilage of the gum for this object. Independently of this 
auxiliary, it would be difficult to prepare a neat castor-oil mix- 
ture, or one that would be readily swallowed. If you triturate 
the oil with a good deal of sugar, you cannot combine the mixture 
with water so as to make a homogeneous mass ; but if you em- 
ploy gum Arabic also, there is little or no embarrassment. 

The foreign books of practical medicine very frequently show 
us prescriptions containing the mucilage of gum Arabic, while 
in this country the gum is generally named, or rather its powder. 
The mucilage is readily prepared by adding four ounces of the 
fine powder of the gum, very gradually, to a pint of boiling 
water, and then rubbing the whole until perfectly blended. 



VINEGAR. 55 

When gum Arabic is adulterated with cherry gum, as is some- 
times the case "with the powder, it is not easy to form a good 
mucilage. Owing to the presenee of cerasin, the proximate prin- 
ciple of cherry gum, it will be ropy. The surest way to obtain 
pure powder of gum Arabic is to pick out the best pieces of solid 
gum and reduce them by active trituration. 

Acetum. Vinegar. — This is the well-known product of the 
acetous fermentation, and needs no description. 

Common vinegar was in use, as a remedy, very many years 
ago. It was once a popular means of arresting the diarrhoea 
and night sweats of pulmonary consumption. Here its effect 
depended on its astringency and tonic power. It has also been 
long in use as a cooling drink in fevers, and in urinary affections 
attended with a white sediment, consisting mainly of phosphate 
of lime and ammoniaco-magnesian phosphate. Its astringency 
makes it a good addition to gargles, and even alone it is often a 
good wash for the throat. It is also frequently applied exter- 
nally, as by sponging, in various febrile affections. Injections 
of cold vinegar are given successfully in cases of uterine hemor- 
rhage. Generally speaking, the undiluted vinegar is employed in 
these cases. 

Vinegar saturated with common house salt has been very 
beneficial in dysentery and scarlatina maligna. A large table- 
spoonful of the mixture is added to four of hot water, and of this 
the patient should take a tablespoonful, as hot as may be, every 
two or three minutes, till the whole is consumed. Mr. Atkinson, 
surgeon, of Westminster, England, speaks well of the use of vine- 
gar in the treatment of arthritic rheumatism. He was led to 
try the remedy in cases in which colchicum and alkalies had 
totally failed, and especially when the digestive organs were 
evidently enfeebled and atonic. The patients had constant pain 
after eating or drinking, no matter how digestible the articles 
might be in other persons. The cases were chiefly old persons, 
or those of middle age injured by dissipation. The common pre- 
scription was the following: — 

R. — Acid acet. gi; 

Tinct. jalap ^i; 

Tinct. cort. aurant. ^i ; 

Misturse camph. ^ss. 

Mix and take twice a day. 

The quantity of acetic acid may be reduced or enlarged, accord- 
ing to its effects. 

I have had no doubt that, in these cases, the alkaline treatment 
had actually induced that state of atony which favors the secre- 
tion of depraved acid matter, and that the acid prescription 



56 ACETIC ACID. 

proved a happy tonic to subdue the gastric debility. (See Lond. 
Lancet, 1847.) 

At a meeting of the "French Academy of Medicine," held in 
November, 1849, two cases of strangulated hernia were reported 
by Dr. Poggioli, in which the return of the bowel was effected by 
the internal administration of vinegar. 

One of the oldest applications to burns and scalds is common 
vinegar; and in lieu of other means it deserves a trial. It is 
said to give prompt relief, but it is desirable to continue the 
application for several hours. A brewer by the name of Cleg- 
horn found it so uniformly successful that he wrote a volume on 
its merits. 

In preparing the spiritus mindereri, vinegar is often employed, 
and very properly. The only objection to it here is the discolor- 
ation of the mixture, growing out of the impurity and dark color 
of the vinegar, which can be readily met by substituting distilled 
vinegar or acetic acid. 

What is called Distilled Vinegar is a purer article than the 
common vinegar, because the process of distillation does not send 
over the grosser and more impure particles. Its properties are 
the same as those of common vinegar. 

Acetic acid is a still purer product, and is variously obtained. 
It is the radical acid of vinegar, and of course is much more con- 
centrated. It is colorless, transparent, and fragrant, and is a 
better article than common or distilled vinegar for making pre- 
scriptions. Its therapeutic properties, however, are pretty much 
the same as those of ordinary vinegar. In addition to the 
properties alluded to, acetic acid is held to be a vesicant. If the 
strongest acid be applied to the skin by means of compress and 
bandage, it will induce vesication. The time requisite will vary, 
according to individual peculiarity, from fifteen minutes to an 
hour. It is also possessed of escharotic power. Thus, if corns 
or warts be pared close with a sharp knife, the remaining ex- 
crescence will be removed in a few days or weeks by the daily 
application of the strongest acetic acid. 

Pyroligneous acid is another form of vinegar that deserves 
notice. It is obtained by the destructive distillation of wood, has 
an empyreumatic or burnt smell, and is of a dark, tarry color, 
unless purified by a second process. From this acid, thus ob- 
tained, a very large quantity of acetic acid is procured by satu- 
ration with lime and the subsequent decomposing energy of 
sulphuric acid. 

In addition to the properties usually assigned to vinegar, this 
acid is decidedly antiseptic, and as such has been much employed 
in medical and surgical practice. The pure article, or diluted 



PYROLIGNEOUS ACID. 57 

with a fourth part of water, applied to an offending surface, cor- 
rects the odor, and sometimes destroys it entirely. 

One of the earliest uses of pyroligneous acid was in the treat- 
ment of excoriated nipples. Dr. Bucharest introduced the prac- 
tice, and directed the acid to be mixed with an equal quantity of 
the white of egg. The mixture should be brought in contact with 
every part of the excoriation by means of a small camel's-hair 
pencil, and repeated morning and evening. 

Tinea capitis has also been successfully managed by the use 
of this acid, the scabs having been removed by the application 
of a soft bread and milk, or mush poultice. The acid is then 
applied to every part of the diseased scalp with a short shaving- 
brush. Two or three applications have sufficed, where attention 
was paid to the general system. This is absolutely essential, in 
all efforts to cure skin diseases wherever located. Indeed, the 
cases are not few in which these affections have yielded to consti- 
tutional measures, unaided by local appliances. And the reason 
why some cases continue to be troublesome for months and years 
is simply the neglect of the general system, while the physician 
tries every prescription that has been advised, for the local affec- 
tion. 

Dr. Babington speaks in high praise of the good effects of 
pyroligneous acid as an application to common ringworm. The 
daily use to the part, for a week or ten days, has generally suf- 
ficed. Here, too, it is often necessary to correct the condition of 
the digestive organs by emeto-cathartics. 

We spoke of the antiseptic powers of this acid, and remark 
that this property led to its use in scarlatina maligna. An 
ounce of the acid, four ounces of water, and a half ounce of 
simple syrup, constituted the mixture, which was employed as a 
gargle as frequently as was practicable. The offensive odor of 
the ulcerated throat is thus corrected, and healthful action pro- 
moted locally as well as in the general system. Dr. Barth, of 
Nuremberg, introduced this practice ; and it is often a good one, 
and merits more attention than it has yet received. 

A word as to the poisonous nature of vinegar, acetic acid, 
and pyroligneous acid, will not be out of place. All may exert 
a poisonous influence. The actual result will depend very much 
on the peculiarity of each case as to constitution, habits, &c. 
Whenever an amount of suffering is realized so great as to 
warrant the suspicion of poisoning by either of these agents, 
magnesia should be given freely, suspended in water or milk 
and water. The design is to neutralize the acid matter, and 
thus to arrest its injurious action. The stomach-pump may be 
employed, at the same time, with advantage. 

In addition to what has been said of the injurious agency of 

5 



58 POISONOUS ACTION OF ACETIC ACID. 

vinegar, we may add that its tendency to produce leanness is 
proverbial. Nor are we prepared to say that all young girls 
who take it, to subdue obesity, are seriously injured by it. It 
is proper, however, to quote the following case, recorded in the 
London Medical Gazette, vol. ii. 1838-9 : — 

"A few years since, a young lady, in easy circumstances, 
enjoyed good health, was very plump, had a good appetite, and 
a complexion blooming with roses and lilies. She began to look 
upon her plumpness with suspicion, — her mother being very fat, 
and she afraid of becoming like her. Accordingly, she con- 
sulted a woman, who advised her to drink a small glass of vine- 
gar daily; the counsel was followed, and the plumpness soon 
diminished. She was delighted with the success of the remedy, 
and continued it for more than a month. She began to have a 
cough, but it was at first dry, and regarded as a cold, that would 
subside. But, from being dry, it was presently moist. A slow 
fever came on, with difficulty of breathing ; her body became 
lean, and wasted away ; night sweats, with swelling of the feet, 
succeeded ; and a diarrhoea terminated her life. On examina- 
tion, all the lobes of the lungs were found filled with tubercles, 
and somewhat resembled a bunch of grapes." 

In addition, we may add that various writers have asserted 
that the long-continued use of vinegar, in full doses, will set 
up chronic diseases of the gastro-intestinal mucous membrane. 
Morgagni says he knew it to induce a scirrhous state of the 
pylorus, with fatal issue. 

Medical men should be fully aware of these statements, and 
be prepared to give proper advice. It is as important to know 
how to prevent poisoning as to arrest its march or palliate its 
consequences. 

There is but one well-authenticated case on record, so far as 
I know, of the fatal action of acetic acid swallowed in large 
doses, and that is detailed by M. Orfila. The following state- 
ment shows that very large quantities of vinegar will also set 
up the symptoms of irritant poisoning. It is taken from the 
British American Medical Journal. The subject was a widow, 
with four children, who took, as near as could be ascertained, 
over a pint of common vinegar. The reporter states that she 
had been low-spirited for two or three days in consequence of a 
sore disappointment, and then adds as follows : — 

" When I saw her, about three hours after she had taken the 
vinegar, she was in bed, covered with a cold perspiration, and 
trembling from head to foot, and apparently alarmed at every- 
body and everything about her. Her breathing was very 
laborious and hurried ; her countenance perfectly wild, and the 
pupils dilated ; the tongue was dry and cold ; pulse ninety-six 



BENZOIC ACID. 59 

and full ; the abdomen much distended, with extremely acute 
pain at the scorbiculus cordis, so much so that the slightest pres- 
sure there caused her to shriek out. She did not know any one 
about her, not even her own children ; nor had she any recollec- 
tion of anything that had happened from the time of taking the 
vinegar, which was about eleven at night, not even of her having 
gone to bed, which she was the last in the house to do. About 
one o'clock the inmates were all awakened by her shrieking for 
cold water, of which she had drunk an enormous quantity before 
I was called to see her. There was not any pain, heat, or con- 
striction of the throat or fauces, but there were slight efforts to 
vomit. Having procured some sulphate of zinc, I gave her two 
scruples in a cup of water, which soon produced full vomiting 
with great straining. I had then to leave her, but ordered full 
and repeated doses of carb. magnesia till I could see her again, 
which I did about six hours after, and found her much relieved, 
and only complaining of headache, which left her after the 
operation of a dose of castor oil. Two days after she was taken 
with a slight attack of continued fever, but is doing well." 

Acidum Benzoicum. Benzoic Acid. Flowers of Benzoin.* 
This acid is seen in white, shining scales, inodorous when pure, 
but generally having rather an empyreumatic odor. The taste 
is pungent, and of a bitterish sweetness. 

Benzoic acid is readily obtained from gum benzoin by heating 
the powdered gum on a metallic plate and preventing the escape 
of the vapors by means of a paper cone. The acid adheres to 
the inside of the cone. 

The gum has been employed occasionally in medical practice. 
The fumes arising from the heated powder are inhaled advan- 
tageously for the relief of colds, and sometimes this expedient 
has been thought beneficial to persons laboring under pulmonary 
consumption. The same use of the gum has been successful in 
a case of aphonia, as we learn from Braithwaite s Retrospect, 
part xvii. p. 98. Asthmatics have been frequently relieved by 
the same kind of inhalation. 

This gum is the product of the styrax benzoin of the Island 
of Sumatra, and is extracted by means of incisions into the bark 
of the tree. 

The benzoic acid (or flowers of benzoin) enters the composi- 
tion of the tinct. oph camphorata (paregoric or asthmatic elixir) 
partly because it augments the expectorant quality of the medi- 
cine, and partly because it improves the sensible qualities of the 
compound. It is unquestionably a good ingredient. 

* Benzoin enters largely into the composition of Pagliaris's mixture for the 
arrest of hemorrhage. (See art. Hemostatic.') 



60 CARBONIC ACID. 

The chief use of benzoic acid in practice is in diseases of the 
urinary organs. In the Medico- Chir. Review for October, 1842, 
we find an account of its successful exhibition in urinary disor- 
ders, with frequent desire to make water, and a sandy and mu- 
cus sediment in the urine. These cases are seen most com- 
monly in old men who labor also under enlargement of the 
prostate gland. The prescription usually employed is thus : — 

R. — Acid, benzoic ^i; 
Copaibse ^ss. 
Mix, with addition of the white of an egg, and add the mixture to 
Mist, camphorat. ^vij. 

The dose is two tablespoonfuls three times a day. In Rank- 
ing' 's Abstract, No. 6, p. 209, is a case of incontinence of urine 
in a girl aged fourteen, cured speedily by this acid. Two drachms 
were made into forty pills, four of which were taken night and 
morning. The acid is, therefore, held to be diuretic as well as 
expectorant. Dr. Ure read a paper before the Royal Medical 
and Chirurgical Society, to show the value of benzoic acid, in 
twenty-grain doses, to prevent the formation of concretions in 
gouty subjects, especially those which are apt to be located in 
the joints and bursse. {Rraithwaite, part iii. page 56.) 

A preparation called benzoin water has been praised, for an 
irritable state of the mucous membranes in all cases where 
there is tendency to earthy deposits, and especially when such 
deposits consist chiefly of lithic acid. This water is made of 
benzoate of potash, biborate of soda, of each fifteen grains, bi- 
carbonate of potash half a drachm, and sixteen ounces of dis- 
tilled water, well mixed, and carbonic acid gas forced into it. 
(See Med.-Ohir. Rev., April, 1844.) 

Acidum Carbonicitm. Carbonic Acid. — We do not intend 
to notice the chemical history of this agent, excepting incident- 
ally. It abounds in nature, combined and uncombined, and is 
largely evolved by all breathing animals. We take large quan- 
tities of it into the stomach in porter, cider, beer, and other 
drinks ; and its peculiarly grateful qualities in the stomach are 
Well known, in reference to the use of Seltzer water and all 
highly-carbonated drinks. The insipidity of water after boiling 
is owing to the expulsion of its carbonic acid gas ; and when 
porter is said to be flat, it is so because its carbonic acid gas has 
escaped. All our effervescing draughts owe this property to 
carbonic acid, and we form them readily by adding to a watery 
solution of a bicarbonate (soda or potash) a small quantity of 
lemon juice, or vinegar, or tartaric acid. 

Carbonic acid is an active ingredient in yeast, that has been 
so successfully employed in low fevers. A tablespoonful of fresh 
yeast given every hour not only calms the irritable stomach, but 



CITRIC ACID. 61 

acts as a gentle stimulant to the whole system. The yeast 
poultice, applied externally to foul ulcers, acts in part by reason 
of its carbonic acid. Two or three tablespoonfuls are mixed 
with an ordinary poultice of bread and milk, and applied night 
and morning, or oftener. It is decidedly antiseptic and stimulant. 

A writer in TillocTis Magazine, vol. i., affirms that carbonic 
acid gas thrown up the rectum has been a very valuable remedy 
in fevers which he designates as putrid; the injection being 
aided by the internal use of Peruvian bark. More recently, car- 
bonic acid gas has been injected into the vagina, for relief of 
dysmenorrhoea. The gas was conveyed by means of a flexible 
tube into the vagina, from a bottle of water highly charged with 
the gas. The bottle was dipped into hot water, and the stop-cock 
of the tube turned so as to allow the gas to escape. Pereira 
reports a very interesting case of a lady cured by this remedy, 
which is supposed to act as a direct sedative. 

Many years ago Dr. Priestley applied carbonic acid gas to 
irritable ulcers, with happy results. In 1795 Ingenhouz an- 
nounced that a stream of the gas directed on an open cancer 
very materially relieved the pain. In phthisis pulmonalis, with 
great irritability of the lungs, diluted carbonic acid gas, taken 
by inhalation, often acted as a palliative, and it deserves further 
trial in this relation. 

The inhalation of carbonic acid gas formed in the combustion 
of charcoal in a close apartment, is a frequent cause of fatal 
asphyxia. In addition to carbonic acid gas there is also evolved 
a considerable quantity of carbonic oxide gas, both of which act 
prejudicially. The burning of the charcoal not only consumes 
nearly all the oxygen of the atmospheric air, which is essential 
to animal life, but this pernicious result is magnified by the for- 
mation of non-respirable gases, not only not diluted, but rather 
concentrated. Persons actually dead, under this influence, pre- 
sent the following appearances, viz., livid spots over the body; 
the tongue protruded and grasped by the teeth ; a sleep-like as- 
pect, resembling that of a person in a profound slumber ; con- 
gestion of the cerebral vessels, amounting to apoplexy, attended 
frequently with effusion into the ventricles of the brain. 

When life is not extinct, the body should be carried out of the 
room to the open air, cold water dashed over the surface, exter- 
nal irritants applied to the extremities, and the lungs inflated 
with common air or diluted oxygen gas. 

Acidum Citeicum. Citric Acid. Lemon Acid. — It is some- 
times called concrete acid of lemons, and salt of lemons. It is 
found in the squill, cranberry, whortleberry, &c, but most abund- 
ant in limes and lemons. In the squill and some other vegetable 
substances the acid exists in a combined state, and hence a diu- 



62 CITRIC ACID. 

retic action results which is not observed in the use of the free 
or uncombined acid. 

Citric acid is prepared by adding powdered chalk to lemon 
juice to saturation. The resulting compound, viz., citrate of lime, 
is decomposed by sulphuric acid, which unites with the lime and 
sets the citric acid free. This latter is then decanted, evaporated, 
and crystalized. 

Pure citric acid is semi-transparent, slightly deliquescent, and 
hence to be kept in close vessels ; the taste is intensely sour, 
rather acrid, and even somewhat caustic. With care it can be 
kept for an indefinite length of time. 

A solution of citric acid and water, equivalent to lemon juice, 
may be made by dissolving nine and a half drachms of the solid 
acid in a pint of water. This preparation answers equally well 
with lemon juice to make effervescing draughts. The carbonated 
alkali is decomposed, a citrate is formed, and carbonic acid gas 
evolved. The following is a very convenient and efficient mix- 
ture for the relief of nausea and vomiting : — 

R. — Bicarb, sod. or pot. gss ; 
A quae %i. 

Mix, and add a tablespoonful of lemon juice, or fifteen grains 
of citric acid dissolved in a tablespoonful of water. Free effer- 
vescence ensues, and the mixture should be swallowed instantly. 
The copious evolution of carbonic acid gas in the stomach re- 
lieves the nausea promptly. 

The high price of citric acid, contrasted with the cost of tar- 
taric acid, leads to adulteration. The fraud can be detected 
with a little difficulty.' Dissolve a drachm of citric acid in a 
tumbler of water, and the same quantity of tartaric acid in an- 
other. Add to both a strong aqueous solution of potash, and 
the difference will soon appear. The potash added to excess to 
the citric acid gives no precipitate ; with the tartaric acid it 
forms a copious white precipitate, which is cream of tartar or 
bitartrate of potash. 

Citric acid has long been regarded as a useful preventive of 
scurvy, and is also employed as a curative agent in the same 
disease. Blane and others think the pure acid less valuable in 
this regard than the juice of the lemon, because the latter con- 
tains vegetable mucilage, which is absent in the citric acid. 

Large doses of lemon juice have been successfully employed 
in the treatment of fevers, as the reader will learn by reference 
to the article Aqua. 

I name another use of citric acid or lemon juice which may 
seem to some persons a little paradoxical, viz., for the cure of 
acidity of stomach. I have proved its efficacy in my own person, 



CITRIC ACID. 63 

and also in the cases of others. After having tried all kinds of 
antacids in vain, I have found strong lemon acid to give very 
prompt relief.* The explanation is thus : a depraved state of 
the mucous membrane lining the stomach, dependent on loss of 
tone, is one of the sources of acidity. The atony must be 
subdued and overcome by an appropriate tonic. This is often 
found in the lemon acid or juice. 

Since the preceding remarks were written, I have met with a 
similar statement from the pen of Dr. Tracy, of Ohio, in the 
American Journal of Medical Sciences. Like myself, he was 
long troubled with gastric acidity, and, after vainly trying all 
ordinary means, was cured by lemon juice. I stated the prac- 
tice in my lectures on Materia Medica several years ago, and 
noticed the fact, also, that persons with stomach and bowel 
derangement depending on excess of acid were sometimes acci- 
dentally cured by draughts of sour buttermilk. 

The following mixture is a very good one for making lemon- 
ade for invalids when lemons cannot be procured : — 

Take powdered citric acid, an ounce and a half; 
White sugar, a pound ; 
Oil of lemon, five drops. 

Rub these well together, and the mixture will keep for years, 
if moisture be excluded. A teaspoonful dissolved in a pint of 
water will instantly make a good lemonade. 

The essential oil of lemons has been employed in the treat- 
ment of subacute ophthalmia. The oil, applied by dropping into 
the eye, or the juice forced out of a lemon-skin into the eye, or 
the aqueous solution of citric acid, will frequently meet the case. 
This practice was first noticed in the London Med. and Phys. 
Journal for July, 1833. The action is, probably, counter-irri- 
tant, and often useful in abating the severity of pruritus. 

Hospital gangrene has been successfully managed with lemon 
juice and chlorine. Jobert was the first to employ this com- 
pound. Roux afterwards tried it in the Hotel Dieu. Lemon 
juice is first dropped into the wound, and a pledget of lint 
soaked in chlorine water placed over it. In a few days the 
parts present a clean and healthy aspect. (See London Lancet, 
Oct. 1845.) 

Pure citric acid, or undiluted lemon juice, taken in pretty 
large doses, may develop poisonous symptoms, especially in 
those who have the gouty diathesis. Severe spasms are often 
thus excited, which call for the immediate exhibition of a solu- 

* And now, seven years after the above was given to the press, it is my surest 
method of relief, for gastric discomfort, to bite off the end of a lemon, and suck 
occasionally from it, so as to consume the whole in a few hours. 



64 HYDROCYANIC OR PRUSSIC ACID. 

tion of bicarbonate of soda or potash. The acid is thus instantly 
neutralized. 

Acidum Gallicum. (See G-alls.) 

Acidttm Hydrocyanicum. Hydrocyanic Acid. Prussic 
Acid. — The present correct name grew out of the well-ascer- 
tained composition of the acid, viz., hydrogen and cyanogen. 
The old name had its rise in the fact that Prussian blue, or 
some of the prussiates, contained this acid. It exists in many 
vegetable substances, and gives them their peculiar and valuable 
properties. The bitter almond, peach kernels, peach leaves, 
wild cherry, &c, contain the acid. Laurel water was known, a 
long while ago, as a poisonous article, and it was employed as a 
remedy in pulmonary consumption before it was known to con- 
tain a particle of Prussic acid. 

Pure hydrocyanic acid is colorless, but it is apt to acquire 
various shades of blue and green by careless keeping, especially 
by leaving the bottle open. Light alters the acid in this respect, 
and hence it should be kept in tight and opaque bottles. The 
strong acid is characterized by an evident peach-blossom odor, 
and this is frequently observed in dissecting bodies after the 
fatal action of the acid. 

The vapors, as well as the acid itself, are injurious. The 
mere inhalation sometimes induces severe headache, nausea, 
and vomiting. One drop of pure acid will speedily kill a large 
dog, if placed on the tip of the tongue or in the canthus of the 
eye. 

What is called the medicinal acid, and sold as such in the 
drug stores, will keep longer than the concentrated kind ; but 
both are liable to spoil. Various methods are in use for pre- 
paring the acid, all of which depend on the union of cyanogen 
and hydrogen in the proper proportions. It is not needful to 
detail them here. One may suffice, and we select it because it 
is the easiest process we know of. Dissolve, in a suitable glass 
vessel, two ounces of ferrocyanicle of potassium (prussiate of 
potash) in eight ounces of pure water, and add an ounce and a 
half of sulphuric acid previously mixed with four ounces of pure 
water and allowed to cool. Place the whole in a retort and 
gently distil, collecting the product in a receiver kept cold by 
means of iced water. In the process some water is decomposed 
whose hydrogen joins some cyanogen of the ferrocyanide to form 
hydrocyanic acid. The oxygen of the water unites with some of 
the potassium to form potash, which combines with the sulphuric 
acid to form sulphate of potash. 

The acid so obtained retains its qualities very well, and it is 
procured at little cost. It is a weaker acid than that which is 
got by the use of the cyanide of mercury. 



HYDROCYANIC OR PRUSSIC ACID. 65 

We have noticed the difference between the medicinal acid 
and the concentrated acid in regard to preservation. But it 
must not be supposed that the former is of uniform strength ; 
and every practitioner should bear this in mind. So great is 
the variety on sale that no precise or specific advice can be of 
use to the purchaser. On this account it is absolutely neces- 
sary, on procuring a fresh bottle, to begin with the minimum 
dose. A case is reported in which this rule was neglected, and 
the patient was killed by the first dose from the new supply, 
although she had been using the acid for several days. We are 
unable to decide the actual strength by the specific gravity test, 
and the method of Dr. Ure is too troublesome to be resorted to 
by most practitioners. That gentleman found that two equiva- 
lents of real acid dissolved exactly one equivalent of peroxide 
of mercury ; of course, the weight of peroxide necessary to satu- 
rate the acid is four times greater than that of the acid itself. 
Hence, on adding any given weight of the mercurial to hydro- 
cyanic acid till it can dissolve no more, we learn precisely how 
much real acid is present by dividing the weight of the peroxide 
taken up by four. This is a simple experiment. 

We hinted at the effect of inhaling the acid, and may add 
that Dr. Reid saw a vigorous young man so much injured by 
smelling some diluted acid that the bottle fell from his hand 
and he remained insensible for nearly an hour. 

Even the very dilute form of Prussic acid, as it exists in the 
cordial, noyeau, has more than once operated as a poison to a 
certain extent. In forming noyeau, the confectioners employ 
peach kernels largely, and these are known to contain the acid. 
In one of the oldest French books of pharmacy a syrup of peach 
leaves is spoken of as exceedingly valuable as an expectorant ; 
and it is altogether probable that modified hydrocyanic acid was 
the efficient agent. 

The acid, taken in large portions, kills with terrible rapidity. 
The case narrated in Huf eland's Journal, of a very large and 
powerful man falling dead instantly on swallowing the contents 
of a drachm vial, is often spoken of. He had been guilty of 
some violation of law, and, fearing its penalty, provided himself 
with the poison, which he swallowed the moment he was arrested. 
Dr. Thompson gives the case of a dog, so large as to be with 
difficulty placed on his lap for the purpose of fixing a drop or 
two on its tongue. The animal was dead before it could be put 
to the floor. So rapid is the fatal action that it can be detected 
in the blood in thirty-six minutes after it is swallowed — so says 
Krimer. 

The poisonous action is not confined to the animal kingdom, 
but extends also to vegetables. The phenomena observed in 



DO PEACH LEAF INFUSION. 

animals are somewhat peculiar. Thus, although vitality in- 
stantly ceases, the eyes continue open and seem to be animated 
as if life remained ; and, although sensibility be entirely gone, 
on opening the thorax the heart is seen to beat feebly, and if 
the abdomen be opened some peristaltic motion is perceptible. 

The symptoms of poisoning by Prussic acid are materially 
different from those which accompany the operation of other 
poisons. Stupor, numbness, sense of weight at the top of the 
head, yawning, drowsiness, vertigo, dimness of vision, flagging 
pulse, vomiting, hiccough, palsy of the extremities, and dilated 
pupils. The respiration is sometimes but little altered. In 
addition, the death shriek is named by some as a symptom that 
is almost invariably present just before death ; but this is a 
fallacy, and entitled to no weight. In nine fatal cases, as 
reported, the alleged death shriek was not an attendant symp- 
tom. The smallest fatal dose of Prussic acid on record was 
nine-tenths of a grain of the anhydrous acid. The largest dose, 
with recovery, was two grains of the same acid. 

Oil of bitter almonds and cherry laurel water act in the same 
way. Dioscorides poisoned wolves with oil of almonds, and a 
noted alchemist killed himself with laurel water to avoid detec- 
tion and mortification. 

Previous to a notice of the practical uses of hydrocyanic acid 
it is proper to speak of the therapeutic properties of peach-tree 
leaves, which contain the acid in a modified form. I regard 
this as decidedly the safest and best exhibition of hydrocyanic 
acid. 

In the Edinburgh Med. and Surg. Journal for 1838, Dr. 
Anthony has published some excellent remarks on the medicinal 
application of the peach leaf. He regards it as decidedly seda- 
tive. He employed an infusion of the leaves in the irritable 
stomach of remitting fever, but does not name the mode of 
preparation. An ounce of leaves to a pint of water would 
answer ; and the best plan is to bruise the leaves in a mortar, 
and pour the boiling water on the mass and let the mixture 
stand for an hour. The adult dose is a tablespoonful every half 
hour, or oftener. The fourth dose generally allays the symp- 
toms, quenches the burning thirst, &c. Such is the relief 
afforded that the patient asks for a repetition of the dose, 
notwithstanding its unpleasant quality. Dr. Anthony applied 
the leaves remaining from the infusion on the epigastrium, in 
shape of poultice, with good effect. Dr. Slaughter, of Georgia, 
assured me that he relied very much on this infusion in the 
treatment of southern fall fevers, because of its anti-emetic 
property. 

The same infusion is reported to have arrested vomiting 



USES OP PRUSSIC ACID. 67 

promptly in two cases of cholera, and to have been very service- 
able in cholera infantum. Dr. Dugas found it a good medicine 
in pertussis ; he gave a pint of the infusion daily in small doses. 

Decoction of peach leaves has been very efficient in urinary 
disorders, more especially in suppression of urine. Dr. Bishop, 
of Kent, (England,) relates his experience with this medicine in 
the eighth volume of Medical Facts. He formed the decoction 
by adding an ounce of the leaves to a quart of boiling water, 
and reduced the whole to a pint by simmering over fresh coals. 
Of the strained liquor a pint was taken daily, and in from twenty- 
four to thirty hours the urine passed freely. 

Touching the therapeutic uses of medicinal hydrocyanic acid 
we have not much to say that is very satisfactory. In its early 
history it did vast mischief, because it was made a kind of pana- 
cea, and was exhibited with very little discretion. Indeed, it is 
not hazarding too much to affirm that it did vastly more harm 
than good. And it is never a safe remedy excepting in the 
hands of very judicious and experienced practitioners. In ad- 
dition to the variable strength of the acid, the fact of its float- 
ing on the surface of water has made it an unsafe medicine for 
general use. Its levity requires the shaking of the bottle before 
a dose is administered. 

The dose of the medicinal acid for an adult is from one to five 
drops. It is best to begin with the minimum dose, and to in- 
crease gradually as circumstances may require. Sweetened 
water or a little syrup will answer very well as a vehicle for its 
administration. 

Dr. Thompson speaks favorably of this acid in the treatment 
of asthma and hooping-cough. In the latter he regards it as 
the main dependence after free vomiting and purging. He in- 
sists on milk and vegetable diet, and the maintenance of a regu- 
lar temperature in the patient's chamber. Dr. Marshall Hall, 
in his work on the Practice of Medicine, confirms the statement 
of Dr. Thompson. He regards asthma as a morbidly excited 
state of the true spinal nerves, and, believing that hydrocyanic 
acid acts by subduing that condition, he holds it to be one of the 
most prompt remedies. Dr. Dickson, in his book on the Unity 
of Disease, says that two drops of medicated hydrocyanic acid 
with a drachm of tincture of lobelia, added to the same quantity 
of infusion of roses, is one of the most effectual remedies that 
can be given for asthma. 

Hydrocyanic may be regarded as especially fitted to influence 
the reflex spinal system, and by this means to allay convulsive 
cough and quiet spasmodic movement. It is very useful in 
gastrodynia, and appears then to act locally on the painful and 



68 USES OF PRUSSIC ACID. 

irritable nerves of the stomach. — Headland's Action of Medi- 
cines, p. 278.) 

Notwithstanding the high laudation of this acid in 'pulmonary 
consumption, I am very sure, from much observation, that it has 
done vast mischief and seldom if ever any real good. It has 
often induced severe stricture of the chest, hemorrhage, and 
other untoward results. 

One of the best uses of the acid is for the relief of high irri- 
tability of stomach. Elliotson has called special attention to its 
value in this regard. One or two doses, of a drop or two each, 
will frequently suffice to arrest a very distressing vomiting. It 
has been spoken of, also, as useful in some of the forms of puer- 
peral mania. 

In pruritus of the genital organs, in both sexes, a foreign 
journal declares that no remedy is comparable with this acid, in 
the proportion of 3iss to gvj of strong alcohol, to be applied 
twice or thrice a day. From five to fifteen days will suffice to 
test its efficacy. It is well worth a trial, for the affection is an 
exceedingly troublesome one, and very difficult to control. 

For the perplexing and almost intolerable itching of erysipe- 
latous and erythematous eruptions, Dr. Thompson declares that 
no expedient is so salutary as a lotion of Prussic acid. This 
may be made by adding one or two drachms of the acid to a 
pint of water, to be applied three or four times a day. The 
strength of the lotion can be safely increased to suit special 
cases. Another lotion of the acid is employed by Thompson, 
made thus : — 

R.— Acid, hydrocy. gij ; 
Acet. plumbi gr, xvi ; 
Alcohol ^ss ; 
Aquse ^viij. Mix. 

This may be applied several times a day, and will generally 
arrest the itching, while it tends also to promote healthful action 
of the skin. It is employed not only in erysipelatous affections, 
but in those herpetic diseases which give so much annoyance by 
reason of the almost insufferable itching. I have found it a 
very useful lotion in my own person. 

In all the cases of cutaneous diseases noticed, the acid is 
thought by many to act only as a sedative ; but as it often sets 
np a new action, it is also held to be a counter-irritant. 

A mixture has been employed advantageously as an expecto- 
rant, prepared with a drachm of the acid in a pint of pure 
water, in which an ounce and a half of white sugar has been dis- 
solved. It is called the hydrocyanic acid pectoral. Care should 
be taken to shake the vial well before dispensing the mixture, as 
the acid will otherwise float on the surface. 



POISONOUS ACTION OF PRUSSIC ACID. 69 

It is well to name the use of the acid to destroy tape worm. 
It was employed successfully in the case of a child three years 
old, from whom some portions of the worm had passed. While 
straining to evacuate, some four or five inches of the worm were 
forced out beyond the verge of the anus, when the acid was in- 
stantly applied. The worm made violent efforts to recede, but 
it was speedily killed and an ell and half quickly expelled. 

Dr. McLeod, an English physician, has recorded the fact, as 
witnessed by himself, that salivation and ulceration of the gums 
resulted in three cases from the use of the acid. This must be 
a very rare circumstance, as no one else has made mention of it. 

The proper method of managing a case of 'poisoning with 
hydrocyanic acid next claims attention. And the first remark 
to be made is that no poision calls for greater promptitude. 
Whatever is to be done must be attended to instantly. True, 
there are peculiar cases in which the poison acts more tardily, 
but these are very few. As a general rule, not a moment should 
be lost by delay. 

There is no proper antidote for this poison, in the true chemi- 
cal sense, excepting chlorine. I therefore place it, as do all the 
recent nad best writers, at the head of the list of remedial ap- 
pliances. The American "Fire King," as he was called, and 
similar buffoons in England, swallowed teaspoonfuls of the acid 
in the presence of their gaping admirers, with entire impunity, 
because they took proper doses of chlorine water, or other pre- 
parations of chlorine. In the same way dogs and other animals 
have been protected against the poison of the acid, given in fully 
poisonous doses. Even after the acid was administered, its fatal 
action was prevented by forcing into the dog's lungs the vapor of 
warm chlorine water. Orfila, who is fully competent to judge in 
cases of this kind, bears testimony to the value of the antidote. 
Its agency depends on the strong affinity of chlorine for hydro- 
gen ; it takes the hydrogen of the Prussic acid, and thus destroys 
its essential nature. If chlorine in any form can be had imme- 
diately, and introduced into the stomach and applied to the nose, 
it promises complete success. But if delay prevent its timely ad- 
ministration, it will be unavailing. 

The most convenient mode of exhibiting the chlorine is in the 
form of the liquid chloride of soda. One or two drachms can be 
added to one or two ounces of water, and of the mixture a tea- 
spoonful should be frequently given, added to sweetened water. 
The undiluted liquid chloride, taken up in a sponge, should be 
applied to the nose, so as to insure the inhalation of the chlorine 
gas as it escapes. The aqueous solution of chlorine will answer 
when it can be had. 

Chlorine has been objected to because of its poisonous nature, 



70 HYDROCHLORIC OR MURIATIC ACID. 

but this is idle. If we must reject remedies that have poisonous 
qualities there would be few articles of Materia Medica left that 
could be available. 

In the absence of the chlorides and chlorine water, the cold 
affusion will be found a very useful remedy. It is not antidotal, 
certainly, though it is capable of meeting many cases of poison- 
ing by hydrocyanic acid very satisfactorily ; if so much vitality 
remain as to render reaction possible, cold water, made more cold 
by the addition of saltpetre or common salt, will rouse the latent 
energies effectually. It should be dashed freely over the head 
and spine and, indeed, the whole surface. 

A few words on the detection of Prussic acid. It is very im- 
portant for medical men to be able to determine with certainty 
the nature of the poison in this and other instances. That none 
may be discouraged in the effort at detection, it is proper to say 
that one part of acid mixed with ten thousand parts of water 
may be detected by the sulphate of iron. To this end add to the 
suspected fluid a little of the solution of sulphate of iron, and in 
a minute or two afterwards a few drops of a solution of pure 
potash, in order to decompose the sulphate and precipitate its 
oxide. Then expose the mixture to the air, and acidulate with a 
few drops of hydrochloric or sulphuric acid, so as to re-dissolve 
a portion of the precipitate. If Prussic acid be present it will 
combine with the peroxide of iron, and a deep blue will be struck, 
showing the formation of Prussian blue. Leuret and Lassaigne 
detected the acid in the folds of the bowels and stomach by cut- 
ting them into small pieces and putting them into a retort with 
some water and a few drops of sulphuric acid. A gentle heat 
being applied drives over the hydrocyanic acid in form of vapors, 
which are easily condensed in a receiver by means of ice or cold 
water. The product in the receiver is easily tested by the addi- 
tion of a few drops of solution of sulphate of iron. 

On opening a body dead from the action of hydrocyanic acid, 
a strong odor like that of peach blossoms is generally, but not 
always, perceptible. 

The acid has rarely been detected later than seven days after 
death. Its easy volatility and decomposition insure its disappear- 
ance sometimes at an earlier period. 

Acidum Hydrochloricum. Hydrochloric Acid. Muriatic 
Acid. Spirit of Sea Salt. Marine Acid, &c. &c. — The name 
hydrochloric is the only correct one, and it is so because it indi- 
cates the composition of the acid, viz., hydrogen and chlorine. 

The acid when pure is transparent, colorless, emitting fumes 
when the bottle is opened that have an acrid, suffocating odor. 
The taste of the acid is exceedingly sour, even when largely di- 
luted with water. We generally see the acid with a yellow tinge, 



USES OF MURIATIC ACID. 71 

which is acquired in part from the iron vessels in which it is con- 
centrated, and partly from the presence of some chlorine and 
nitric acid. 

Hydrochloric acid is prepared from the muriate of soda (common 
salt) by the decomposing power of sulphuric acid, which liberates 
the acid in form of gas ; and this, going into vessels containing 
water, is readily absorbed by that fluid. When the water is suffi- 
ciently charged with the gas, it becomes the hydrochloric acid 
under notice. It is, however, subsequently exposed to heat to 
concentrate it. One hundred grains of good acid will saturate 
one hundred and twenty-four grains of carbonate of soda. 

Hydrochloric acid is usually called a mineral acid, and yet it 
is a natural constituent of animals, especially man, and might, 
therefore, be called also an animal acid. Owing to the sulphuric 
acid employed in making the hydrochloric, a slight trace of it 
may be detected by dropping into it a few drops of muriate of 
barytes. If the smallest portion of iron be present, it can readily 
be detected by means of prussiate of potash. 

Hydrochloric acid has been employed in medical practice in- 
ternally and externally. In the undiluted state it has been ap- 
plied to warts, corns, and other excrescences, with success. Here 
it acts as an escharotic. It is also an ingredient in gargles for 
ulcerated sore throat and ulcers of the mouth ; and in these cases 
it acts partly as an escharotic and partly by setting up a new 
action. It may be employed diluted with water only, or with the 
addition of honey, which makes it more efficient, thus : — 

R. — Acid, hydroch. ^ij ; 

Mel. opt. sjss ; 

Aquae ^iv. 
Misce. 

Sometimes we can most conveniently apply the acid on a small 
piece of sponge fastened to a stick of whalebone six inches long. 
Brought in contact with ulcers of the mouth and throat, it is 
frequently an excellent expedient. The diphtherite of Breton- 
neau has been successfully treated in this way. 

Injections of very diluted muriatic acid have been resorted to 
in the treatment of gonorrhoea ; for this purpose from five to ten 
drops are added to four ounces of water. But this mixture can 
hardly be proper, unless depleting measures have been adopted to 
reduce inflammatory action. Velpeau employed hydrochloric acid 
to arrest salivation. He applied the pure acid by means of a 
camel' s-hair pencil, three or four times a day to the gums and 
other parts affected by the mercurial action. A pellicle forms on 
the parts, and the morbid action is arrested, so as to cease almost 
entirely at the end of two or three days. 

Chilblains or frost-bites have been very happily treated with 



72 MURIATIC ACID AS A POISON. 

this acid. The frosted parts should be made as clean as practi- 
cable, and then the whole surface be covered with the acid 
applied on a soft brush. 

A writer in the American Journal of Medical Sciences, vol. 
xvii., asserts that hydrocloric acid largely diluted with water is 
an excellent remedy for colic induced by red lead ; while sulphu- 
ric acid is successful in colic from white lead. The naked fact is 
stated, apart from any explanation. 

Hydrochloric acid has long been in use as a stimulant and 
tonic in malignant, typhus, and scarlet fevers. The usual mode 
of administration was a mixture of one drachm with four ounces 
of water, tablespoonful doses being given every hour or two, 
according to circumstances. Paracelsus employed this acid in 
what were called in his day putrid fevers. When the mixture 
spoken of is given in scarlatina anginosa, it is not only taken 
into the stomach to affect the general system, but it is also 
gargled more or less, and so acts, locally, to advantage on the 
throat. 

Dr. Paris and some others hold this acid to be an excellent 
medicine to prevent the formation of worms, as well as to dis- 
lodge them when actually present. The bowels must be well 
evacuated in the first instance, and then the acid should be given 
in an infusion of quassia. This compound is evidently a potent 
tonic, and may act as such, and also by some special quality of 
the acid itself. My son, Dr. B. Rush Mitchell, of the U. S. 
Navy, in a paper which appeared in the Western Lancet, sug- 
gested that worms were formed in the stomach when the natural 
hydrochloric acid was entirely absent. This is more than pro- 
bable. 

Hydrochloric acid is also exhibited in cases of copious white 
sandy, deposit in the urine, depending on excess of alkaline or 
earthy matter. It acts by neutralizing the latter and establish- 
ing an acid predominance. In order to effect this it should be 
administered for several weeks. When it acts thus it is called 
antilithic and lithontriptic. The old doctrine is the doctrine of 
the present day, touching the entrance of this acid into the blood, 
not only when employed in urinary diseases, but whenever it is 
taken into the stomach as a stimulant and tonic. 

The usual adult dose of the acid is from five to twenty drops in 
a wineglassful of water. The diluted acid of the Pharmacopoeias 
is made by adding four ounces of pure acid to twelve ounces of 
water. One of the most agreeable vehicles for the exhibition of 
the acid is the infusion of roses. 

Hydrochloric acid is also antiseptic. The dry salters of meat 
in England always add this acid to every barrel of meat intended 
for long voyages, because of its preservative tendency. 



NITRIC ACID. 73 

We notice briefly the poisonous action of hydrochloric acid. 
The acid gas is pernicious to animals and vegetables. Small 
animals die in it, even when diluted, very speedily. A lawsuit 
was instituted in Liverpool some years since, in which it appeared 
that horses, cattle, and men, in passing by a factory where the 
acid was manufactured largely, were seized with cough and diffi- 
culty of breathing. Here is evident irritation of the mucous 
membranes, and the acid is properly called an irritant poison. 

The acid, swallowed in ounce doses, is decidedly poisonous. 
Orfila gives the case of a man thus poisoned, although he reco- 
vered under proper treatment. The antidotes are scraped chalk, 
whiting, calcined magnesia, or soap dissolved in water. A direct 
chemical union results between the acid in the stomach and these 
antidotes, and thus the poison is rendered inert. If neither of 
the articles named can be had, milk, whites of eggs, demulcents 
generally, may be given freely, after the stomach has been well 
evacuated. 

Acidum Nitricum. Nitric Acid. Aqua fortis. — These 
names are given to an article essentially the same, only varying 
very much in strength. The strongest nitric acid is the maxi- 
mum of oxygenation of which nitrogen is susceptible. The pure 
acid is transparent and colorless. Exposed to the air, it emits 
suffocating fumes of reddish-brown color. A bottle of the acid 
unstopped absorbs moisture from the air, and, of course, it is thus 
weakened. It is exceedingly acrid and caustic, staining the skin 
of an indelible yellow, and staining clothing in the same way. A 
fluidounce, weighing eleven drachms and a scruple, will fully 
decompose an ounce of pure limestone. The pure acid is fifty 
per cent, heavier than water, boils at 220°, and freezes at 62° 
below zero. 

Nitric acid is made from nitrate of potash by the agency of 
sulphuric acid, sulphate of potash being formed, and nitric acid 
liberated in the form of gas. The acid gas is passed into a ves- 
sel of water, which readily absorbs the gas and acquires acid 
properties. When newly made, the acid abounds in yellowish- 
red vapors, which are easily driven off by heat. Exposure of the 
acid to light changes it more or less. If a hundred grains of the 
acid neutralize two hundred and twelve grains of crystalized car- 
bonate of soda, the inference is that the acid is very strong. 

A fraction of sulphuric acid may be present in nitric acid by 
reason of its agency in the manufacture, and this can be readily 
detected by the muriate of barytes. 

We shall notice this acid, as a therapeutic agent, in the follow- 
ing aspects, viz., as an eschar otic, epispastic, tonic, expectorant, 
disinfectant, and as a poison. 

As an escharotic it is entitled to more attention than it usually 

6 



74 USES OF NITRIC ACID. 

receives. Its promptitude of action results, necessarily, from its 
decided power over animal tissue of every kind. Hence it has 
long been applied to warts and corns, and other excrescences. 
In these cases it is best to use the strong acid, because of the 
density of the parts and their insensibility. Its application to 
parts bitten by rabid animals is not quite so safe as some sup- 
pose. It may stimulate the absorbents to take up the poison, 
and so accelerate and secure its fatality. To old, foul, indolent 
ulcers, we may apply it very beneficially. The strong acid clears 
off the surface and sets up a new and more healthful action. It 
should be laid on by means of soft lint, or a hair pencil, night 
and morning, to be followed by a cerate cloth or soft poultice. 
Welbank and others speak very well of its use in sloughing 
phagedenic ulcers. Some surgeons apply the acid to the ulcer- 
ated scalp in tinea capitis, first cleaning off the surface with soap- 
suds or a poultice. Then the acid is brought in contact with the 
diseased spots by means of a piece of sponge. The strong or 
diluted acid must be employed according to the state of the 
parts, the long continuance of the disease, &c. The solution of 
Sir Astley Cooper, though suitable for many cases of ulceration, 
would be too feeble, generally speaking, for scalled head. He 
added fifty or sixty drops of pure acid to a pint of water. 

Equal parts of nitric acid and water constitute a mixture that 
has proved very useful in ulceration of the gums and lining of 
the mouth, as may be seen in Braithiuaite s Retrospect, part xvi. 
p. 185. In chronic ulceration of the ear, emitting a fetid dis- 
charge, a mixture of ten drops of the acid in eight ounces of 
water will be found very useful in form of injection. A drachm 
of this mixture thrown into the ear two or three times a day has 
put a stop to the disease in less than a week. 

Some very striking cases of the cure of obstinate hemorrhoids 
are reported by Dr. Massy, Physician to the Exeter Dispensary, 
in the London Medical Times for June, 1849. The application 
to the tumors was pure nitric acid. A farmer, aged thirty, had 
been an invalid for years with bleeding piles, which came on 
gradually, but increased so as to be very troublesome, causing 
the loss of half a pint of black blood immediately after a stool. 
The tumor had two bleeding surfaces, and an excoriation nearly 
an inch square. To move his bowels as easily as possible he 
took a wineglassful of the following mixture : 

R. — Infus. sennae ^vi; 

Sulph. magnes. sjiv ; 

Cart>„ magnes. t ^iss. 
Mix. 

The first application of the acid was made soon after the 
bowels were evacuated, by touching the bleeding surface by 



USES OF NITRIC ACID. 75 

means of a feather. The spot soon turned white, and was 
covered with sweet oil. On the next day, the tumor was very 
much lessened, and bled but little. On the following day, the 
acid was re-applied, and once more at the end of a week. In a 
few days the disease was wholly gone, and the patient was able 
to attend to his business. 

Other cases are reported, of like character. (See Braithwaite, 
part xx.) 

The epispastic power of nitric acid might be inferred from. its 
known action on animal fibre. The blistering property is resorted 
to only in urgent cases, where it is desirable to make a sudden 
and powerful impression. On these accounts the acid was 
employed for the purpose of vesicating, during the prevalence of 
epidemic cholera many years ago, and with obvious benefit, as 
we learn from the Edinburgh Med. and Surg. Journal for 
Oct. 1830. A mixture of two parts of acid to one of water is 
applied by means of a soft sponge ; and, in order to control in- 
stantly its too violent action, a solution of potash (carbonate or 
pure) should be at hand, to be applied with another sponge or a 
soft cloth. "Vesication occurs in a few seconds, and the cuticle 
being detached presents a raw surface admirably suited to the 
purposes of endermic medication or for the application of a fly 
blister. 

As blending the escharotic and epispastic properties, I name 
the nitric acid ointment, which has been a good deal employed 
in the management of porrigo, scabies, and to syphilitic ulcers. 
It often very speedily gives a healthful impulse to the parts 
affected, and thus changes, happily, the character of the morbid 
action. The ointment is made by adding gradually two drachms 
of nitric acid to one pound of melted hog's lard. The mixture 
should be placed over a slow fire, and stirred with a glass rod till 
ebullition begins, and then set aside to cool. If found too strong 
for use in any given case, it can easily be weakened by rubbing 
with more lard. The ointment is of a bright yellow, and quite 
firm. The acid is decomposed during the process, and the fat 
oxidized. 

The tonic powers of nitric acid have been very highly extolled. 
As the tonic quality generally refers to the internal use, the acid 
is employed in a diluted state. And here it is needful to say 
that the term diluted acid is not very definite. This is owing 
to the fact that nitric acid, as sold in the shops, is of variable 
strength, and consequently the subsequent dilution will present 
an article having by no means a uniform power. The physician 
who has a quart of acid on hand will, of course, be able to have 
a diluted acid of uniform strength until his supply of pure acid 
is exhausted. One part of acid to nine of water is the usual 



76 USES OF NITRIC ACID. 

manner of dilution, and of such a mixture the adult dose is from 
ten to forty drops in a tablespoonful of water or in some bitter 
infusion. I have given it in much stronger solution. Two 
drachms in six ounces of water make a tonic mixture which can 
be dispensed in teaspoonful doses added to sweetened water three 
times a day. In all cases of the internal administration of this 
or other mineral acids, the teeth should be carefully protected by 
sucking the solution through a glass tube or a quill, and washing 
the mouth with a weak solution of carbonate of soda. 

Some have objected to the use of dilute nitric acid as a tonic 
because of its tendency to derange the stomach and to set up 
ptyalism. But these objections are more theoretical than prac- 
tical. Others have regarded the acid as antiphlogistic, and thus 
they suppose it to act in some hepatic and syphilitic affections. 
Eut in all such cases the action is partly tonic, at least, and 
partly alterative. 

The tonic action of nitric acid is happily illustrated by Mr. 
Wilkinson, surgeon, of London, in the London Lancet for 1845. 
He regards it as specially suited to diseases dependent on a 
morbid state of the blood-vessels. We quote as follows : — 

" The point to which I wish to call the attention of the pro- 
fession is, that the virtues of nitric acid are but imperfectly un- 
derstood, and that in it we have not only a most powerful and 
valuable tonic, but, I was going to say, almost a specific, in cer- 
tain diseases kept up by vascular debility. I have no disposition 
to detract from the virtues of the various drugs and chemicals we 
so often make available in the treatment of disease ; on the con- 
trary, in the hands of a judicious practitioner, one whose genius 
can at once mark the symptoms as they arise, there is, perhaps, 
scarcely a single drug in the Pharmacopoeia that has not, in 
some degree, its curative or alleviating properties. Mercury, for 
instance, which is the sheet-anchor of the physician, would be 
little else than a deleterious and deadly poison were it not for the 
vegetable and saline purgatives ; to say nothing of opium, anti- 
mony, and other remedies, for which the Materia Medica and 
Laboratory are so justly esteemed. 

" I was first led to the trial of nitric acid as an internal me- 
dicine by observing its effects when applied externally to ulcers 
and inflammatory surfaces when the blood-vessels had undergone 
some morbid change. In varicose veins, if a piece of lunar 
caustic, the basis being nitric acid, or nitric acid not too strong, 
be drawn along the distended vessel, it will penetrate the skin, 
and in three or four days the vein will be reduced in size and 
the morbid inflammation and pain removed, or at all events con- 
siderably lessened. In varicose ulcers of the legs, where the 
surrounding parts are of a livid or bluish cast, a solution of 



USES OF NITRIC ACID. 77 

nitrate of silver or nitric acid will often cause the vessels to 
shrink, assume a healthy condition, and ultimately disappear. 
Of course if any mechanical obstruction, such as pregnancy, 
exist, or the valves above be diseased, these circumstances must 
be taken into account, and the cause, if possible, removed. Il 
the liver and kidneys do not perform their office, these secretions 
must be attended to. The application of bandages is known ma- 
terially to assist when the patient can bear pressure. In caries 
of a tooth, if a drop of pure nitric acid be . introduced into the 
hollow of it, the disease is immediately arrested and the pain 
ceases. I have tried this repeatedly, and almost always with 
success ; but much depends upon the state of the liver and intes- 
tinal canal at the time, which, if disordered, tends to keep up the 
morbid inflammation in the part. 

" The inference I drew from these observations was that if 
nitric acid could be introduced into the system in sufficient quan- 
tity, in cases where the blood-vessels were in a debilitated or dis- 
eased state, so that the circulation might be in a manner saturated 
and the extreme arterial and venous branches affected, similar 
results might be accomplished where a more general and consti- 
tutional disorder existed. The following is the first case I selected 
for trial : — 

" Case 1. — E. D , aged thirty-nine, carrying on the busi- 
ness of a coach-maker in London Wall, in the city, was brought 
to me in the month of October, 1839, laboring under dropsy of 
the abdomen, with diseased liver. When he entered my room, 
he was supported by his friend, Mr. Lester, who came with him. 
His countenance was sallow and shrunken, his abdomen and legs 
swelled to an enormous size, the latter resembling in shape the 
limbs of an elephant. His scrotum hung half-way down his 
thighs, and the skin of his penis was distended to the thickness 
of a man's' arm. His pulse was small and weak, and beat not 
more than thirty strokes in a minute. His history was soon told. 
He had been a constant frequenter of a public house, had been 
ill about two years with a diseased liver, and then dropsy had 
supervened about ten months before paying me his first visit. 
He had been under medical treatment, and taken mercury in 
small doses, with other remedies, but was now considered by his 
medical attendants as past cure, and unable, from his weak state, 
to undergo the operation of paracentesis. His bowels at this 
time were costive ; he passed his urine in small quantities, not 
more than a tablespoonful at a time. I ordered him six grains of 
calomel and ten of colocynth, in three pills, to be taken at bed- 
time. I visited him at his own residence two days afterwards. 
He had passed two motions, both as black as, and of the consist- 
ence of, melted pitch. I desired him to repeat the dose, and saw 



78 USES OF NITRIC ACID. 

him again in two days ; he had passed three motions, the first two 
in color and consistence as the last, but the third was more of a 
brownish cast, and looser. From his uneasy state and difficulty 
of breathing, in the presence of Mr. Hunt, apothecary to the 
Provident Dispensary, I passed a trocar below the umbilicus, and 
drew off a pail and a half of water. The fluid, on being placed 
in an iron spoon over a candle, was found to be highly albuminous. 
I did not examine his urine. Took six grains of hyd. cum creta 
at night, a drachm of supertartrate of potass, with eight grains 
of jalap, on the following morning. The evacuation was watery, 
and contained yellow bile. This was repeated in four days with 
a similar result ; pulse continued the same in frequency, but fuller. 
Ordered friction over the region of the liver with the palm of the 
hand three times a day, an hour at a time. I now determined to 
give the nitric acid, beginning with thirty drops of the dilute 
every four hours, in a glass of decoction of cinchona. This was 
increased ten drops per diem till he took two hundred and fifty 
daily, and continued it for two months. The dropsy had entirely 
disappeared, and his pulse risen to ninety in a minute, and full. 
The secretion of bile and urine had returned; he could eat a 
beefsteak for breakfast, and was ready for another before his ac- 
customed hour for dining, which was one o'clock. In less than 
six months he was as fat and as well as ever he had been during 
his life. The most singular part of this case is that my patient 
afterward returned to his old habits of drinking, but, I believe, 
not to his former excess. I saw this person three years after- 
wards ; he had no return of his complaint whatever. He took 
the nitric acid nearly three months. There is one thing here I 
wish to point out, viz., that in all cases of obstinate obstruction 
of the liver a large dose of calomel must be given ; small doses 
are worse than useless. 

" Case 2. — Thomas P , aged fifty-two, butler to Mrs. 

C , of Montague Square, consulted me in the month of Oc- 
tober, 1840, about a large tumor in the throat. The apothecary 
who attended him told him that it was an enlarged tonsil gland. 
On making an examination I found a large tumor occupying the 
left side of the fauces, descending down the pharynx, but its ex- 
tent in that direction could neither be seen nor felt. It ascended 
behind the bony palate, and continued its course along the roof 
of the mouth ; below, it pressed down the tongue, and pushed the 
velum palati diagonally forward as far as the teeth. On one 
side it was connected to the pharynx by a base as broad as the 
tumor itself, whilst the other surface came nearly in contact with 
the opposite side of the throat. The tonsil on the diseased side 
seemed involved in the disease, but whether it commenced in that 
gland or lower down does not appear, as he never suspected the 



USES OF NITRIC ACID. 79 

existence of such a companion till it had assumed the frightful 
size of a turkey's egg. The mucous membrane covering the 
tumor was tense, and somewhat glistening, of a dullish-red color. 
It had not the least doughy feel, but was semi-elastic in some 
parts, whilst other portions of the swelling had a firm, fleshy feel. 
His countenance was rather sallow, but from his general good 
health I proposed the operation of removing it piecemeal by liga- 
ture, as it was evidently too vascular and in too awkward a situa- 
tion for the knife. His mistress had sent him to Mr. Lawrence, 
of Bartholomew's Hospital, who pronounced it malignant, and 
would not interfere with it. I then proposed that Mr. Liston 
should see him, when it was agreed to pass a bistoury straight 
into the tumor and evacuate any fluid that it might contain. A 
small quantity of straw-colored fluid was evacuated from a super- 
ficial puncture, but on the instrument being continued further 
downward a rush of arterial blood took place and he lost nearly 
a pint in less than two minutes. Cold vinegar and water and 
syncope fortunately put a stop to the hemorrhage, and I accom- 
panied him home from the hospital in a coach. In a day or two 
he had a great deal of irritative fever, the lips of the wound 
opened, and an excrescence, having a yellowish- white cauliflower 
appearance, protruded. This kept on increasing in size for six 
weeks, was hard to the touch, and now of a magnitude between 
a shilling and a half-crown. His appetite entirely failed him, and 
he could scarcely swallow fluids of the consistence of arrowroot. 
The debility of body was now much increased ; he had lost all 
his flesh, his countenance very sallow, and his features much 
attenuated. The glands of his neck on the side of the tumor 
formed a chain along the sterno-mastoid muscle as hard as marbles ; 
he was literally skin and bone. Mr. Liston and myself, who 
daily attended him, now thought that death would soon terminate 
his existence, and my friend took his final leave. Mr. Aston 
Key, of Guy's Hospital, was now sent for, and I met him. He 
pronounced it at once a fungus, that in all probability he had 
another in his liver, and that the patient would not live four days. 
Though all hopes seemed now at an end, I observed that he would 
constantly call for the nitric acid gargle which I had ordered him. 
I was therefore determined to give large doses of it internally, 
which I did every four hours, beginning with thirty drops, thrice 
a day, in a glass of water, increasing five drops each dose per 
diem. In less than a week the excrescence sloughed and came 
out ; the nitric acid was continued, and he got rapidly well in six 
weeks. T. P. is still in his situation, in good health, and has 
been so ever since Ins recovery, four years and a half ago. 

" In justice to that well-known and accomplished surgeon, Mr. 
Liston, I must confess that without that gentleman's operation 



80 USES OF NITRIC ACID. 

the patient would, in all probability, long ago have been either 
choked or starved. Without the nitric acid he would most inevi- 
tably have sunk. 

" Case 3. — I was consulted in the year 1839, by Mr. W , 

an ironmonger, in Crawford Street, about thirty years of age, 
for an ulcer on the upper part of the ala of the nose. It was 
first observed about three years before, in the shape of a small 
pimple, which discharged a watery tumor. He had been under 
half a dozen surgeons, but none of them could succeed in getting 
it to heal. I advised him to take five grains of Plummer's pill 
every night, and Hudson's syrup of sarsaparilla during the day, 
for a month. At the end of the first week I applied the lunar 
caustic, which I repeated at convenient intervals, which checked 
the discharge ; and I was in hopes, when the black eschar had 
separated, that cicatrization would have been completed. I was, 
however, disappointed. A very thin skin certainly had come 
over it, but I saw it was soon to be absorbed, which was the case 
in a week afterwards. Its base being very hard, and his friends 
alarmed lest it should turn out cancerous, I proposed to dissect 
it out. The thoughts of the operation frightened him, and he 

went to Mr. C , a well-known surgeon in the borough, who 

advised him to continue what I had before prescribed, probably 
thinking I had not pushed the medicine far enough. This gentle- 
man applied the caustic more freely ; the result was, however, the 
same. When about six months had elapsed he sent for me, and 
I removed the hardened base and ulcerated surface, which was a 
little larger than the section of a large pea. I had some difficulty 
in getting the wound to heal, the granulations being glassy and 
ash-colored. A little diluted nitric acid was applied to the wound 
with a camel' s-hair brush for four or five successive mornings. In 
a fortnight it assumed a more healthy appearance, and it was 
healed in a month after the operation. It caused little or no 
scar, the part resembling a pit from the smallpox. It has never 
again returned. The patient took the nitric acid internally during 
the healing process. 

" Case 4. — Mr. S , aged sixty, a tobacconist, an old in- 
habitant of the Edgeware road, long subject to erysipelas, ob- 
served, in the month of September last, a small tumor on the 
middle of his right eyelid of a dark-red color. It increased in a 
month to the size of a horse-bean, when he pricked it with a 
needle, and says he lost about a gill of blood. The puncture soon 
increased in size, and an excrescence made its appearance which 
had grown, by the middle of November, to the size of an old 
English strawberry. In this state I first saw it ; he had then a 
poultice to his eye, which, from its pressure and the tumor to- 
gether on the globe, had produced considerable inflammation of 



USES OF NITRIC ACID. 81 

the conjunctiva. As he was under medical treatment, I refused 
to interfere, but considered a poultice, from its weight, at all 
times a most inapplicable thing for the eye. This was changed 
for something worse, — namely, a zinc lotion, which produced 
considerable inflammation both of the eye and eyelid. As the 
surgeon thought an operation useless, believing it to be the true 
carcinoma, I was consulted professionally. The tumor was hard 
to the touch and easily bled, and profusely, considering its size. 
It was composed of one sac within another, so that when its sur- 
face appeared to be about to suppurate it would come off, and 
the sac underneath make its appearance. The eyelid was swollen, 
of a dark-red color, and could not be raised by the patient. On 
opening the eye, there was chemosis of the conjunctiva, the 
cornea sunken and dull, and two large patches of lymph thrown 
out. I ordered him a constant application of warm water, three 
grains of calomel and a quarter of a grain of tartar emetic 
directly, with a black draught two hours afterward. I saw him 
again at night ; medicine had operated ; put a blister behind his 
ear. He afterward took small doses of blue pill for three or 
four days, and applied another blister. The inflammation had 
sufficiently subsided for the nitric acid and bark, which he took a 
week previous to the operation. 

" I performed the operation as follows : — The patient being 
seated in a chair opposite a window, I stood behind him, and he 
reclined the back of his head on my breast. Mr. B lizard Power, 
a student of Bartholomew's, who assisted me, stood in front, and 
fixed the prongs of a hook I use in the squinting operation just 
above the tarsus, and put the eyelid on the stretch. With a 
small scalpel I made a circular incision around the base of the 
tumor, having only just room for the blade of the knife between 
it and the cartilage. It was very vascular, and I was obliged 
to pause more than once that I might see my way clear. As 
the sac was incorporated into the lid, I took in a little skin with 
its circumference, and, behind, a few of the fibres of the orbicu- 
laris palpebrarum. I got it clean out, but the hemorrhage, con- 
sidering the small size of the tumor, was almost incredible. The 
patient lost more than half a pint of blood, and I had great diffi- 
culty in stopping it, as I could not use pressure in so delicate a 
situation, and it was desirable for the oozing to cease ; so I dressed 
the wound simply with a piece of gold-beater's skin. My patient 
continued the nitric acid for a fortnight afterward, and he got 
well in three weeks. 

" It would require the eye of a very acute person to see where 
this operation had been performed. There is not the least shorten- 
ing of the lid, nor even stiffness in it. He says his sight is better 
than it has been for years, and I am sure his general health is, if 



82 USES OF NITKIC ACID. 

a most excellent appetite is any criterion. I think it will be some 
time before he has another attack of erysipelas. 

" I make it a practice of giving the nitric acid and bark before 
and after operations for scirrhous breast, in chronic erysipelas, 
and immediately after the acute stage of that disease ; in debility 
after an attack of gout, and in most nervous diseases ; in extreme 
old age I have found it increase the appetite, raise the spirits, 
and induce sleep, where opium and other narcotics have tended 
to keep up the disorder they were intended to remove. In val- 
vular affections, and enlargement of the heart by dilatation, I 
have found the most decided benefit, especially if the liver per- 
forms its office tolerably. Of course, in such cases as the last, a 
cure could not be expected or even looked for, and I have seen 
quite enough of digitalis to discard it in toto. If the nitric acid 
is taken for some time, it raises the pulse, renders it fuller, but 
deprives it of its wiry hardness. It does not destroy the teeth, 
like the other mineral acids, nor turn them black. I have never 
seen it produce salivation, but it will cause great redness of the 
mucous passages, the tongue, and fauces." 

After some ambiguous details as to the nature of hooping-cough. 
Dr. Gibb furnishes the London Lancet with his experience in the 
treatment of this disease by nitric acid. He says his friend, Dr. 
Arnoldi, has treated more than one hundred cases of pertussis 
with this medicine with the most pleasing results. " Since I be- 
gan its use," says Dr. Gr., : 'I have cured sixty-seven patients, 
the time consumed averaging between six and seven days, — some 
as low as two, others protracted to fifteen, days. It is affirmed 
that the remedy arrests the paroxysms, removes the hoop, and 
shortens the disease almost as certainly as quinine does an ague. 
The strength of the dose is not given. But if the dilute acid be 
composed of one part strong acid to nine of water, (the usual 
rule,) then a child eight years of age might safely take six to 
eight drops every four hours, blended with a tablespoonful of 
the syrup of lemon." 

The theory offered by Dr. Arnoldi may go for what it is worth, 
but the fact is infinitely more valuable, if real. It is conjectured 
that the nitric acid is, somehow or other, decomposed by the vital 
powers, and the oxygen and nitrogen, especially the former, dif- 
fused through the whole system. Well, this is one of the possi- 
bilities, I suppose. The practice was given first in the London 
Lancet, August 12, 1854. 

The nitro-muriatic bath merits a passing notice, and is fairly 
to be regarded as a tonic remedy in very many cases, although 
it may at the same time evince some power as a counter-irritant. 

This bath is made, for the most part, by combining two parts 
of hydrochloric with one part of nitric acid, and adding this mix- 



USES OF NITRIC ACID. 83 

ture to water until it excites a stinging sensation on the hand 
and arm. To reach this result, about five ounces must be added 
to three gallons of water. The acid mixture is sometimes called 
the nitro-hydrochloric solution ; but there is neither nitric nor 
hydrochloric acid present in the mixture, both acids being decom- 
posed and chlorine being evolved. 

The chief uses of this bath refer to hepatic and syphilitic 
affections. Some physicans have been quite extravagant in its 
praise, whilst others have denounced it as comparatively worth- 
less. Paris aflirms that he has seen the bath of vinegar and 
water quite as potent for the same ends. I am compelled to say 
that I have never observed any very striking results in favor of 
the remedy. 

Nitro-hydrochloric (nitro-muriatic) acid has been lately used, 
says Dr. Headland, as a remedy for gout and rheumatism, in 
spite of the acid state of the fluids in those cases ; and he believes 
it to be a very valuable medicine in both of these disorders. The 
compound acid must operate in some special way. — Action of 
Medicines, p. 223. 

Dr. Headland could not have forgotten the large doses of 
lemon-juice given in the diseases named above, and no one who 
ventures on such portions has any fear because of the acid state 
of the fluids. The inference might be made with equal force 
that citric acid has a special action. We regard it as a depurator 
and eliminator of morbid matter. 

A German professor (Ith) advocated a bath made of equal 
parts of the two acids very decidedly. He says he found it suc- 
cessful in cases of intense cephalalgia and hypochondriasis, and 
in obstinate constipation. His common practice was to put the 
legs, up to the knees, in the bath every evening for six or eight days 
successively. The local effects were slight redness and swelling. 
The general health was obviously improved. 

The expectorant power of nitric acid is unquestionable, even 
in its uncombined form ; and the same property is found in all 
the acids. But it is chiefly in combination that this acid has been 
found useful as an expectorant. The nitric lac ammoniac of 
Stuart is decidedly expectorant, being specially suited to persons 
of feeble constitutions. The original recipe is given in the work 
of White on Colds, the American edition of which was edited by 
Dr. James Stuart, of Philadelphia, (deceased,) and is as follows: 
—Infuse 5\j of pure nitric acid in a half pint of pure water, and 
add the mixture gradually to two and a half scruples of the best 
gum ammoniac. Rub well in a glass mortar until all the gum is 
dissolved and a homogeneous milky fluid results. The dose is a 
tablespoonful in six tablespoonfuls of sweetened water every three 
or four hours. 



84 NITRIC ACID AS A POISON. 

As a disinfectant, the vapors of nitric acid once occupied a 
high place, because of a foolish act of the British government. 
The fancied discovery was made by Dr. Carmichael Smyth, and 
yielded him the neat sum of five thousand pounds sterling, 
although, in reality, it was not worth a farthing. The infinitely 
superior powers of chlorine have cast this wonderful discovery 
into the shade. 

The doctrine of incompatibility applies with great force to 
nitric acid. On this subject there is, unhappily, a great amount 
of ignorance in the profession, which should not be permitted to 
remain. Paris notices this subject in very appropriate terms, and 
cites particularly the administration of dilute nitric acid and 
blue pill, in alternate doses, as a practice by no means unusual. 
The risk here is the formation of a poisonous salt of mercury. 
On the same principle of incompatibility, magnesia should not be 
given to a patient who is taking nitric acid as a tonic. The tonic 
property would be lost, because a true salt of nitrate of magnesia 
would result. These may serve as illustrations of a practice that 
a little study might rectify. 

Of Nitric Acid as a Poison. — It is important for every phy- 
sician to be able to determine that this acid has been the occasion 
of poisoning. The color it leaves on the skin and on clothing 
will assist, as well as the peculiar suffocating vapors emitted by 
the acid. The speediest experiment is made by throwing a few 
copper filings into a little of the suspected acid, when copious 
red fumes will be given out, if nitric acid be present. A salt of 
morphia is reddened instantly by a drop of the acid. We also 
prove the acid to be nitric by saturating it with potash and evapo- 
rating to get a crystaline salt. On the supposition that the acid 
was nitric, the salt formed must be nitrate of potash. By dividing 
the salt into two parcels, and casting the one on red-hot coals, we 
shall be satisfied that the salt is nitre, and hence that nitric acid 
was present by the deflagration of the salt. The other half of 
the salt being placed on a watch-crystal, a particle of a salt of 
morphia carefully laid on it will be reddened by a drop or two of 
sulphuric acid brought in contact with the lower salt as soon as 
the glass is heated with a spirit-lamp. The action is to effect the 
decomposition of the lower saline matter, thus setting its acid 
free and allowing it to act on the morphia. The latter being 
reddened is additional proof of the presence of nitric acid. A 
French journal furnishes the following very delicate test : — Add 
a small portion of pure strong sulphuric acid to the suspected 
acid, and when cool add a few drops of a strong solution of 
proto-sulphate of iron, which will instantly strike a rose or pur- 
ple color. One part of nitric acid may thus be detected in 
twenty-four thousand parts of water. 



POISONOUS ACTION OF NITKIC ACID. 85 

We can also detect the acid in the stains upon clothing. The 
spots are so permanent that they may be detected seven weeks 
after the accident. The spots must be cut out carefully, and 
then boiled in pure water in a watch-crystal or small retort. 
The solution thus obtained will prove to be very acid to the 
taste, as well as shown to be so by litmus paper. If the solution 
be nitric acid the proof can be had by an experiment like the one 
before detailed, viz., by adding a solution of potash, evaporating 
and crystalizing. 

It is not easy to name any fixed quantity of nitric acid as a 
dose necessarily poisonous. The force of this remark will be 
obvious from the mere notice of a fact given in the work of 
Tartra, published in 1802. It is stated that a female sot in 
Paris became alcohol and brandy proof, and resorted to aqua 
fortis as a substitute. So callous had her stomach been rendered 
that it bore the acid without complaint. As a general rule, the 
effect of any poison will depend much on the previous habits of 
the person, the state of health, the fullness or emptiness of the 
stomach. 

The recital of one or two cases of poisoning by nitric acid will 
be found useful for reference, and as guides to the practitioner. 
Mr. Arnott has reported an interesting case in the Lond. Med. 
Gazette. A boy, aged thirteen, swallowed nitric acid in mistake 
for beer, and probably took as much as a dessertspoonful of the 
acid. He was seen some hours after the accident occurred, and 
appeared to be suffering from acute laryngitis. Before arriving 
at the hospital frequent portions of calcined magnesia in water 
had been given, which were soon ejected by vomiting. From 
the first he was very cold, and continued so. The operation 
of laryngotomy was performed by Mr. Arnott, but with little 
benefit. The respiration was rough and difficult, pulse frequent, 
face pale, the tongue of citron color ; and when roused he made 
brief replies, which increased his sufferings. He could not put his 
tongue out, nor swallow. There was great pain all around the 
throat, for the relief of which leeches were freely applied. The 
breathing became more and more difficult, and gave a sound like 
a whistle. In thirty-six hours the case ended fatally. 

It is proper to say that the citron-color of the tongue and in- 
tense coldness are always present in cases of poisoning by this 
acid. They are pathognomonic signs. 

Another case is given in which recovery ensued, although the 
man died ultimately of some of the consequences. A man, aged 
thirty-four, swallowed a wineglassful with the design of killing 
himself. Spontaneous vomiting soon followed, and of course 
much of the poison was ejected. Calcined magnesia was given 
freely, and the patient was depleted by general and local bleed- 



86 SULPHURIC ACID. 

ing, which did not prevent the occurrence of intense gastritis. 
The treatment was persevered in, and at the end of eight days 
the man was taken to La Oharite. At the end of three weeks 
he left the hospital. 

The best antidote is, evidently, calcined magnesia. But com- 
mon magnesia will answer, or the scrapings of whitewashed walls, 
or any of the alkalies. The design is to neutralize, at once, all 
the acid in the stomach. A watery solution of soap will accom- 
plish this end effectually, the potash in the soap being the anti- 
dote. In the absence of these, milk, starch, broth, gruel, &c, 
may be tried. An objection has been raised to the use of an 
alkali, as potash, because the nitrate of potash, so formed, is 
itself a poison. But this salt is given, as a remedial agent, 
in quantities ten times larger than the portion formed in the 
stomach in the use of the alkaline antidote. Let no one, there- 
fore, hesitate to give a solution of soap at once, if neither mag- 
nesia, nor chalk, nor old mortar can be procured. 

Some have advised the use of the stomach pump, but it is not 
necessary. 

Acidum Sulphuricum. Sulphuric Acid. Vitriolic Acid. 
Oil of Vitriol. — Pure sulphuric acid is a compound of oxygen 
and sulphur. The strongest commercial acid contains more or 
less water, and the acid is strong or weak in proportion to this 
addition. The specific gravity varies from 1.8 to 1.9, and an 
acid of this strength requires a heat of 590° for ebullition. If a 
bottle of strong acid be long exposed to the air, the stopper being 
out, the moisture of the atmosphere is copiously absorbed. On this 
account the vessel containing the acid should be kept well stopped. 

The acid is manufactured on an extensive scale by the oxy- 
genation of sulphur in large leaden chambers, the acid so formed 
being taken up by water in the bottom of the chamber. The 
fluid is afterwards evaporated so as to concentrate the acid. If 
quite pure it is transparent, colorless, inodorous, of an oily con- 
sistence, highly corrosive, exceedingly sour even if copiously 
diluted, and instantly reddening vegetable blues. 

The actual strength of the acid can be determined only by its 
neutralizing power, ninety-two grains saturating one hundred 
grains of carbonate of soda. One fluid ounce of full strength 
weighs fourteen drachms. If the bottle containing the acid be 
closed with cork instead of glass, the acid will be speedily dis- 
colored, acquiring a brown or even a black tinge. This tendency 
of cork is known to quacks, and they avail themselves of the 
knowledge to impose the more effectually on the ignorant. A 
miserable creature called at my house many years ago, when I 
resided in a country village, introducing himself as a poor un- 
fortunate doctor, who had been engaged in a good practice in 



USES OF SULPHURIC ACID. 87 

some part of Great Britain, but having been overtaken by mis- 
fortune, left for this country in the hope of getting a livelihood. 
He begged me to make him a present of a lancet, as that would 
help him to a little money now and then for the operation of 
bleeding. I complied with the request of the poor creature, 
although he was by no means a deserving object. Some four or 
five days after a letter came to my address from the same travel- 
ing doctor, in which he thanked me most cordially for the lancet, 
adding a prescription for cancer with which I might " make a 
fortune." It was simply to blacken sulphuric acid with cork, 
and call the mixture "Mitchell's Black Cancer Drop." 

Sulphuric acid has been frequently employed as an external 
remedy. It entered the composition of Sir Benjamin Brodie's 
liniment in the proportion of from one to three drachms of acid 
to one ounce of sweet oil. The mixture is rubbed smartly on the 
part, as on the knee or hip, and intended to act as a powerful 
counter-irritant. It operates, in the first instance, as a rube- 
facient merely, but by frequent repetition it sets up actual ulcer- 
ation. Old indolent ulcers have also been managed with the 
strong acid, the surface being quickly cleaned off and a new 
action set up. A mixture of half a drachm of the acid and an 
ounce of lard has been successfully employed in scabies and simi- 
lar affections. 

The internal administration has been quite extensive. For 
this end the diluted acid is always resorted to in one of two 
forms of preparation. These are the well-known elixir of vitriol 
and the acid diluted with water. The former, called also acidum 
sulphuricum aromaticum, is made thus : — 

R. — Acid, sulphuric, three fluid ounces and a half; 
Alcohol, a pint and a half; 
Cinnamon, bruised, an ounce and a half; 
Ginger, bruised, an ounce. 

Add the acid gradually to the alcohol, and digest by a very 
gentle heat for three days in a close vessel. Add the powders, 
digest for six days more, and strain. The dose is from five to 
ten drops in half a tumbler of water. 

We remark that this preparation is not at all necessary, hav- 
ing no sort of advantage over the more simple mixture made by 
dilution with water. Brande, Paris, and Maugham give place 
to sulphuric acid diluted with water, and reject the alcoholic 
preparation. The following is the mode of preparing the watery 
solution: — Take strong sulphuric acid, a fluidounce and half, 
distilled water, fourteen and a half ounces. Mix gradually. 

This solution is a very convenient article, and may be given in 
doses of from ten to thirty drops, in a little cinnamon water. 

Diluted sulphuric acid is often preferable to other acids in the 



55 USES OF SULPHURIC ACID. 

management of diarrhoea, hemorrhages, excessive sweating, &c. 
&c, because of its peculiar astringency, added to its tonic power. 
The old elixir of vitriol was Sydenham's favorite remedy in epi- 
staxis and hemoptysis. A good vehicle for its administration is 
an infusion of gentian, tansy, columbo, chamomile, or quassia. 
If the acid induce constipation, it may be given in a small quan- 
tity of a solution of sulphate of magnesia. Should griping pains 
be induced, a quarter of a grain, or less, of sulphate of morphia 
may be added. 

The London Lancet and Medical Times for 1851 and 1852 
contain several papers setting forth the happy effects of sulphuric 
acid in the treatment of cholera and diarrhoea. Twenty to thirty 
drops of the diluted acid in an ounce and a half of water make a 
dose for an adult, to be repeated every hour. The first dose 
sometimes induces vomiting, and then it may be better to give the 
medicine once in two hours, and after a day or two once in three 
hours. A few days suffice for a cure. 

Time was when to name sulphuric acid as a remedy for diar- 
rhoea or any bowel affection would have excited astonishment, 
owing to the fact that long usage had confided the treatment to a 
very different class of articles. Now we know that a common 
diarrhoea may be managed with castor oil or with this acid, that 
dysentery can be cured with calomel or catechu, while cholera has 
been subdued by opium as well as by castor and croton oil. In 
the most obvious case, viz., in simple diarrhoea, both plans are 
appropriate, but at different periods of the attach. Something 
is formed in the blood which should be excreted : it may be merely 
an increase of a natural excretion. If it pass not out by nature's 
effort, we call to our aid one of the cathartics named, just to in- 
sure the result. That may not suffice because of high irritation 
in the canal, and because an unnatural flux may be set up there. 
Then it is that a different sort of article comes to the rescue, which 
we often name an astringent, as sulphuric acid diluted with water, 
or in the shape of the elixir of vitriol. We are sometimes called 
in when nature has been evacuating too freely from the bowels, 
and when a cathartic might be deleterious. Then we succeed, 
happily, with sulphuric acid. Hence its frequent success in 
cholerine and profuse diarrhoea. I speak from experience. 

In slight uterine hemorrhage in feeble constitutions I know of 
no better medicine than the diluted sulphuric acid given in cold 
tansy tea. It should be persisted in for weeks. In Asiatic 
cholera this acid was employed by Greenhow, of England, in the 
following manner : — 

Take of infusion of cloves, six ounces ; 
Diluted sulphuric acid, one and a half ounces ; 
Tinct. of opium, twenty-four drops. 



POISONOUS ACTION OF THE ACID. 89 

Mix. Dose, two tablespoonfuls every hour till the discharges 
are checked, after which the dose is given once in two hours. 

The diluted acid is an effectual medicine for the arrest of pro- 
fuse perspiration, especially as connected with phthisis pulmo- 
nalis. It should be given at bedtime, in doses of from five to 
twenty drops, in chamomile tea. 

Rather recently attention has been called to the use of sul- 
phuric acid lemonade for the prevention and cure of colica pio- 
tonum. Gendrin directs it to be prepared by adding from one 
and a half to two drachms of the acid to three pints of water. 
This quantity should be taken in the course of twenty-four hours ; 
and it is affirmed that thus employed the medicine will cure lead 
colic in from three to six days. As a preventive, two wineglasses 
of the lemonade are to be taken daily, the body being well washed 
with warm soapsuds every night. (See Lond. Lancet, May 31, 
1845.) 

Diluted sulphuric acid has been employed successfully in the 
management of the itch, in Prussia. Dr. Schroeder, of Gottin- 
gen, says he has cured the disease with it in fourteen, days at the 
farthest, and often in less time. Given to nurses, it is said to cure 
both them and the children. The formula is as follows : — 

R. — Acid, sulph. gi ; 
Aquae gv ; 
Syrup, simp. giij. 

The dose varies from a scruple to a drachm three times a day, 
in a wineglassful of pure water. It is said that this prescription 
is best suited to plethoric subjects. (Med. Commentaries, 
vol. i.) 

A case of obstinate hiccup is reported in vol. vii. of Med. Com- 
mentaries as promptly relieved by diluted sulphuric acid. The 
patient was seventy-three years old, and had resorted to all the 
ordinary remedies. A mixture of one drachm of the diluted 
acid and four ounces of mint water was prepared, of which a 
tablespoonful was directed to be taken every half hour. The first 
dose caused the hiccup to cease instantly, and a quiet sleep en- 
sued which continued all night. As the complaint returned on 
the next day, another dose was taken, and there was no repetition 
of it afterward. 

The obviously corrosive action of sulphuric acid on animal 
structure has led to the belief that the acid never enters the blood. 
That this is a mistake, however, is manifest from well-known facts. 
If you give the diluted acid to a suckling woman, the infant will 
suffer from cramp and colic induced by this agency. But the 
question is settled by a fact recorded in a German journal for 
1828. A woman poisoned herself with strong sulphuric acid. 

7 



90 SULPHURIC ACID AS A POISON. 

The last efforts of nature were exerted to give birth to a child, 
and on dissection sulphuric acid was detected in the cavity of 
the child's pleura and peritoneum, in the sac of the heart, and in 
the bladder. 

Sulphuric acid claims attention as a poison. The great weight 
of the acid should prevent the accidental swallowing in place of 
water. But it has often been taken, purposely, to destroy life. 
It has been poured down the throats of persons asleep, and into 
the ears. Infants have been destroyed in this way by diabolical 
nurses. The acid has also displayed poisonous energy in per- 
sonal combat, in which it has been squirted into the face, eyes, 
&c. &c. This infernal expedient had its origin in England, but 
it has been resorted to in our own country also, and special sta- 
tutes have been enacted against the vice. 

Whenever personal violence is done by this acid, more or less 
of it falls on the clothing, giving it a deep-red stain, and con- 
siderably weakening the texture of the fabric. These stains are 
far from being transient ; but, as moisture is absorbed rapidly, 
the acid or sour quality of the stained spot gradually becomes 
less obvious. The spots will suffice for proof of the kind of acid 
for at least fourteen days in ordinary clothing, as we learn from 
the Edinburgh Med. and Surg. Journal, vol. xxxi. Christison 
detected a sixteenth of a grain of the acid in two small spots on 
a blanket seven weeks after the accident occurred. 

The pieces of spotted cloth should be cut out carefully, and 
boiled in pure water in a watch-crystal or a very small retort. 
This being done, let the fluid be tasted, and tried with litmus 
paper. To a part of the fluid add a few drops of a solution of 
the muriate of barytes, which will give a copious white insoluble 
precipitate if the acid be sulphuric. 

So terribly and quickly poisonous is this acid that the cele- 
brated Dupuytren was induced to exclaim, " Can a person be saved 
who has swallowed it ?" But recoveries have taken place, and that 
too in the cases of tender infants. 

In all instances of swallowing large portions of sulphuric acid 
the result must be governed very much by the previous habits, 
the general health, the fullness or emptiness of the stomach, &c. 
Hence we account for recovery after a large quantity has been 
taken, and for death from a much smaller portion. Hence, too, 
the variety in the symptoms as to severity. The irritation of the 
stomach and bowels will be much more intense in one case than 
in another ; so will the pains, spasms, &c. vary. 

The antidotes are the same as we named for the poison 01 
nitric acid. The external injuries inflicted may be mitigated very 
much by the copious use of oil. I knew a lad who was employed 
in a drug store who was seriously injured by the fracture of a 



USES OF TANNIC ACID. 91 

large bottle of this acid. The contents fell on his breast and 
ran down to his feet. Instantly he sprang from the front door of 
the shop and speedily got into an open oil cask in the cellar, 
which was about half full. The oil soon blunted the activity of 
the acid, and no doubt lessened the evils of the accident. The 
ulcers induced in this case were exceedingly painful and indolent, 
and the lad was confined to his chamber for nearly five months. 
Could an individual meeting with an accident of this kind 
jump instantly into a river, the dilution would be so vast as to 
mitigate very greatly the corrosive quality of the poison. But 
it would not answer to apply water by sponging, or even pouring, 
unless the operation could be repeated without intermission for 
some time. A moderate dilution of the acid would develop an 
intense heat, and thus do harm. 

Acidtjm Tannicum. Tannic Acid. Tannin. — This is a 
peculiar substance largely abounding in gall-nuts in connection 
with gallic acid. It is a principal cause of astringency in the 
articles designated as astringents procured from the vegetable 
kingdom. It can be obtained in an impure form largely from 
catechu, by solution in water. A much purer article is procured 
from powdered galls, by the agency of sulphuric ether. 

This acid being a very powerful astringent, may be used in lieu 
of ordinary astringents, and is preferred by some physicians to 
all others of the class. The Italians have employed it largely in 
uterine hemorrhage. The usual dose is three grains, made into 
pill with mucilage of gum Arabic or conserve of roses, and given 
every three or four hours. It has also been used to arrest or 
moderate excessive perspiration, in doses of from half a grain to 
two grains at bedtime. Several cases of diabetes have been cured 
partly by the exhibition of tannic acid, as follows : — 

R. — Acid, tannic, ^ij ; 
Pulv. opii, gr. ss. 

Mix, and divide into three parts, — one to be taken morning, noon, 
and night, in syrup or made into a pill. The quantity of the acid 
was gradually increased, daily, with the effect of decided amend- 
ment in ten or twelve days. 

In chronic diarrhoea the following prescription has been em- 
ployed successfully : — 

R. — Acid, tannic, gr. x; 
Cons, rosar. 3[ij ; 
Tinct. opii, 7 drops. 
Mix, and take in three doses in the course of a day. 

During the late prevalence of Asiatic cholera the tannic acid 
was resorted to with good effect to check the intestinal discharges. 
But an error was sometimes committed by adding laudanum in 



02 USES OE TANNIC ACID. 

place of a salt of morphia to the prescription. The latter avoids 
incompatibility. Thus :— - 

Take of tannin, ten grains ; 

Sulphate of morphia, two grains ; 
Aromatic spirit of ammonia, 
Tincture of red pepper, each a half ounce ; 
Camphorated water, four ounces. 
Mix, and give to an adult a teaspoonful every hour until relieved. 

A solution made by adding five grains of the acid to an ounce 
of water has been a very serviceable application to sore nipples. 
It should be applied night and morning, taking care to protect 
the parts against further injury from the operation of sucking. 
The usual nipple-shield will suffice for this purpose. The same 
solution is very prompt in relieving sore mouth attended with 
small ulcerations, that often affect the breath badly. 

Solutions of tannin have been highly commended in the shape 
of lotions to the eye for the relief of chronic and acute conjunc- 
tivitis, cowieitis, &c. &c. The solution of M. Hairion is much 
stronger than any before used, consisting of one part tannin to 
three of pure water. He has also employed it in powder and 
ointment. It is held to be a safe and very successful remedy. 

Dr. Lange, of Konigsberg, Prussia, has had large success with 
tannin in gonorrhoea. From a half drachm to two scruples are 
added to two ounces of water to make an injection, which is to be 
thrown up the urethra three times a day. The ages of the patients 
ranged from seventeen to forty-three years, and the disease had 
lasted several weeks, and even six months. They were cured in 
from six to nine days. No pain followed the use of this remedy. 
— Braithwaite, xxiii. p. 215 ; also, part xxvii. p. 162. 

Care must be taken to have inflammatory action reduced prior 
to the use of the remedy in such cases ; and it is important to 
see that the bowels be kept in a soluble state. 

In that troublesome affection called fissure of the anus or 
rectum, an ointment made of one part acid and fifteen lard has 
been employed with excellent effect. The gut having been cleaned 
out by one or two warm water injections, a portion of the oint- 
ment as large as a cherry stone is to be rubbed over the parts 
once or twice a day. If the disease extend high up, an injection 
of the acid will be important once or twice a day. 

As this disease is not described by many writers, the following 
brief note will not be amiss : — The rent or fissure is induced by 
pregnant females, who become very costive and strain severely 
in order' to have a stool. The rent being made, will continue 
under the repetition of efforts of a like nature, and the edges be- 
come callous. Sometimes an aphthous state of the parts is also 
found to increase the evil. To determine the fact of the pre- 



TARTARIC ACID — ACONITE. 93 

sence of the fissure, the lower bowels are to be injected with 
warm water to clean the lining membrane. Then, with the fore- 
finger oiled, the patient bearing down, pass it up the rectum, and 
you will find the rough and hardened condition spoken of about 
an inch within the verge of the anus. The fissure is seldom more 
than an inch in length. 

Acidum Tartaricum. Tartaric Acid. — This acid exists 
largely in cream of tartar or the bitartrate of potash. To the 
latter, first boiled in water, powdered chalk is added until all ex- 
cess of tartaric acid in the bitartrate is neutralized. The result- 
ing compound is tartaric acid and potash, called tartrate of potash. 
This is decomposed by sulphuric acid, which seizes the potash, 
forming sulphate of potash and setting the tartaric acid free. 
This is subsequently evaporated and crystalized. 

Tartaric acid is present in the juices of all acid fruits, but 
most largely in the juice of the grape ; and hence the bitartrate 
of potash spoken of already is formed in great quantities in the 
process of making and ripening wine. 

The chief use of tartaric acid in the practice of medicine is in 
the formation of effervescing drinks. To this end it enters the 
composition of soda powders, so much employed in domestic 
economy ; and it acts an important part also in Seidlitz powders. 

But the acid has been employed largely in manufacturing what 
are called lemonade powders, and also in preparing lemon syrup. 
In both instances a fraud is practiced, although with little or no 
injury to the system. 

The lemonade powders are made of tartaric acid, sugar, and a 
little essential oil of lemon ; but they contain no citric acid nor 
lemon juice. The lemon syrup, as it is called, is made by boil- 
ing tartaric acid and water together and adding enough sugar to 
constitute a syrup. To each bottle nearly filled with this article 
about five drops of oil of lemon are added, to give the desired 
flavor. 

In very large quantities tartaric acid sets up the symptoms of 
irritant poisoning. To meet such a case recourse must be had 
to the antidotes advised in respect of poisoning by nitric acid. 
A very satisfactory case of the poisonous action of tartaric 
acid is recorded in the London Lancet, vol. i. of the New York 
reprint. 

Aconitum Napellus. Aconite. Monkshood. — This plant 
is common in the forests in various parts of Europe, and is to be 
found in this country as an ornamental flower. The leaves 
should be gathered just before the flowers begin to fade. These 
are of a dark violet-blue color, large and beautiful. After the 
seeds have ripened the sensible properties of every part of the 
plant are lost or greatly lessened. The leaves and tubers should 



94 ACONITE. 

be cut into slips and dried with care at a low temperature. 
The roots are not unlike the carrot, only having a dark-brown 
color. 

The fresh leaves have a decidedly narcotic odor when rubbed 
between the fingers. The taste is at first bitterish, then burning, 
very acrid and abiding. If the leaf be chewed for several minutes 
it will excite inflammation of the tongue. The root exhibits the 
same properties as the leaf, and from it is separated the proxi- 
mate principle, aconitina, a vegetable alkaloid. 

The poisonous nature of aconite has long been known, having 
been resorted to for the purpose of destroying criminals under 
sentence of death. 

Although the leaf is decidedly poisonous, it loses that property 
by long ebullition. The British Flora Medica speaks of a man 
who noticed a female gathering the leaves of monkshood, and, 
fearing a serious accident, he inquired what she meant to do with 
them. The reply was, "lam going to cook them, as greens, for 
dinner." The man followed her home, watched the process, saw 
the boiling and subsequent eating by the family without the least 
perceptible injury. The deleterious property had all vanished 
under the action of a high temperature. 

The absolutely poisonous action of the green leaf, unchanged 
by heat, is evinced by the following fact: — a person became 
maniacal, as his friends supposed, from eating the green leaf; a 
surgeon who was present ridiculed the idea, and even denied that 
the vegetable was at fault, and to confirm his declaration ate 
freely of the leaves himself and perished in great agony. 

The therapeutic properties of aconite and aconitina are ano- 
dyne, sedative, diaphoretic, diuretic. Physicians in former 
times employed aconite in gout, rheumatism, secondary syphilis, 
cancers, epilepsy, palsy, dropsy, &c. Dr. Turnbull called the 
attention of medical men to it, in several essays, as a remedy for 
rheumatic and neuralgic affections. He employed it in two 
forms, viz., in alcoholic solution and ointment. One grain of 
aconitina to a drachm of alcohol gave the former, two grains to 
a drachm of lard made the latter. A small quantity of either is 
to be rubbed on the affected spot night and morning, and to be 
continued for a week or ten days. 

Aconite is a powerful anaesthetic to the superficial sensory 
nerves. When applied in solution or ointment to the surface of 
the skin it produces, first, some heat and tingling, which is attri- 
butable to a derangement of nervous influence; and this is fol- 
lowed by perfect numbness. It is thus a most valuable topical 
remedy in true irritative neuralgia. — Headland's Action of 
Medicines, p. 278. 



ACONITE. 95 

Dr. Franceschi, of Petersburg, Russia, employs the following 
mixture in Asiatic cholera : — 

R. — Tinct. aconit £iij ; 

Tinct. opii giss ; 

Ext. aloes zi. 
Mix. 

Ten drops are to be taken every morning in a spoonful of 
Madeira or coffee, as a prophylactic ; and when the disease is 
formed the dose is from ten to thirty drops. How often it 
is to be given is not stated. (See London Lancet, January, 
1850.) 

It is reported that traumatic tetanus has been cured by tinc- 
ture made as follows : — Take of the root of aconite, dried and 
powdered, sixteen ounces ; and of alcohol, sixteen fluidounces. 
Macerate these during four days ; strain, and add enough alcohol 
to make twenty-four ounces. The dose is five drops three times 
a day or oftener. 

It is related in the Journal de (Jliimie Medicale for July, 1827, 
that an old woman had been in the frequent habit of taking a 
tincture of lovage for some real or supposed malady, and usually 
prepared it herself. One day her complaint gave her more trouble 
than usual, and she took an ounce before supper, another after, 
and a half-ounce at midnight. She died in the course of the 
night. Not long after this, three of the family took an ounce 
each of the old lady's cordial, and were taken ill in half an hour. 
One of them had inexpressible anguish and sense of burning in 
the throat and stomach, vomiting, purging, tenderness of the 
epigastrium, and colic, afterward delirium, manifesting itself in 
loud cries and violent running ; but emetics and emollient drinks 
calmed his sufferings, and in two days he recovered. Another 
man of weaker habit of body began to stagger, and appeared in- 
toxicated, then was seized with violent vomiting, purging, and 
acute, colic pains, and died in two hours. The third, a young 
female, complained of a sense of burning and enlargement of the 
tongue, and then of burning along the gullet to the abdomen ; she 
was soon attacked with shivering, swelling of the face, vomiting, 
purging, and violent colic, and died in a state of great agita- 
tion two hours and a half after drinking the cordial. The bodies 
were examined, and the only appearance of note was great red- 
ness of the inner membrane of the stomach and small intestines. 
A medico-legal examination having been ordered, M. Degland, 
physician at Lille, discovered that the tincture had been made of 
the roots of the Aconitum napellus. 

As the alcoholic extract of the Aconitum napellus is sometimes 
employed medicinally, the following cases will be useful, as a 
warning at least, and may serve to keep doses within due bounds. 



96 POISONOUS ACTION OF ACONITE. 

It is given in the Journal de la Societe Royale de Medecine de 
Bordeaux, Juin, 1839. A man forty-five years old entered the 
Hospice St. Andre with a painful rheumatic affection, for the 
cure of which the alcoholic extract of aconite was directed. He 
took two grains in the morning and the same in the evening, 
and on the tenth day the pains were moderated. On the next 
day, the old stock of extract being exhausted, his pills were 
taken from a new parcel, and although of the same size and 
weight, they induced, in a quarter of an hour, trembling of the 
muscles of the thighs, legs, and arms, and darting pains, which 
grew worse and worse. These were followed by convulsions, 
continuing for a quarter of an hour at a time. The mouth and 
throat were extremely hot, and vomiting followed every effort to 
swallow. In the convulsions the patient was insensible, but this 
state subsided with the paroxysms, leaving, however, an enfeebled 
state of the organ of vision. He complained now and then of 
severe lancinating pains in the head, as if a bar of red-hot iron 
had been thrust through the brain. 

The only remedy said to have been effectual in this case was a 
strong infusion of huaco, (Eupatorium huaco,) which alone re- 
mained on the stomach. Vomiting ceased, and a happy reaction 
was established, followed by speedy recovery. 

Another patient in the same hospital, who took also of the 
fresh parcel of extract after the old was exhausted, died in about 
four hours. 

Willis has the case of a man who accidentally ate some of the 
leaves of aconite as a salad, and died mad in a very short time. 
Matthiolus mentions the circumstance of four robbers under sen- 
tence of death to whom this plant was given, two of whom, after 
suffering the most violent torments, were saved by appropriate 
remedies, but the other two died. One of these became in a few 
hours idiotic, his face bathed in a cold sweat, with total loss of 
sensation and then with fainting and spasms, &c. &c. 

In the London Philosophical Transactions is given the case 
of a man who ignorantly ate of aconite leaves in a salad. In- 
stantly he was seized with burning heat in the tongue and gums 
and great irritation of the cheeks. He felt no disposition to 
vomit, but after drinking a pint of oil and a large bowl of tea he 
vomited considerably. The symptoms grew worse, and in two 
hours after taking the aconite a surgeon saw him. Then his 
eyes and teeth were fixed, his feet cold as ice, his body covered 
with a cold sweat, his pulse imperceptible, and respiration almost 
extinct. Some spirit of hartshorn was administered, which in- 
duced coughing and vomiting. Then an infusion of the blessed 
thistle [Qarduus benedictus) was given till he vomited copiously. 
After a short interval he had a stool, and the vomiting was re- 



POISONOUS ACTION OF ACONITE. 97 

newed slightly. His pulsf rose a little, and intermitted with 
great irregularity. A mixture of an anodyne character was then 
prescribed, and he soon recovered. 

In the Edinburgh Medical and Surgical Journal we have a 
statement, extracted from an Italian periodical, showing the fatal 
action of the juice of the Aconitum napellus, taken for the relief 
of a scorbutic affection. Twelve persons, on the 11th of June, 
1840, took nearly two and a half ounces each of this juice in 
mistake for that of scurvy-grass. The oldest of the twelve, aged 
sixty, suffered first. His respiration was soon much embarrassed, 
vomiting came on, and these, with bad treatment, caused his 
death in a few hours. Two of the company were women, aged 
fifty-five, and they died in two hours after having swallowed the 
poison, laboring under convulsions, partial paralysis, and great 
prostration. The other nine were all severely affected, and 
would have died if relief had not been promptly afforded. The 
symptoms in their cases were, great mental and bodily prostra- 
tion ; dilated pupils ; the countenance pale, and much altered in 
expression ; vertigo and headache ; painful and swollen state of 
the abdomen ; vomiting of greenish matters ; some diarrhoea ; a 
sensation of cold ; nails of a livid hue ; cramps in the legs ; pulse 
small, feeble, and scarcely perceptible. 

Emetics were first given to excite vomiting. Then tonics and 
stimulants, as tincture of canella, rum, and wine, followed, even 
to intoxication ; the limbs were well rubbed with spirituous lotions. 
Under this course the nine got well. 

Dissection of those who died revealed the usual effects of nar- 
cotico-acrid poisons, but with more inflammatory signs than are 
usual. The pia mater and arachnoid membranes were much 
injected with blood, and a good deal of serous fluid was seen at 
the base of the brain. The lungs were engorged. The heart was 
flabby, containing black blood, which distended also the large 
vessels. The stomach had many irregular injected patches, 
especially near to the large curvature, and it contained a quan- 
tity of viscid ash-gray colored liquid. The small intestines were 
also somewhat inflamed. 

A very interesting case is copied into Braithwaite s Retro- 
sjiect, part xvii., in which it is stated that two and a half grains 
of aconitina failed to kill, although evidently a poisonous dose. 
Convulsive vomiting and imperfect hydrophobia ensued, with 
frightful collapse. The case is reported by Dr. Golding Bird, 
who thinks that the greater part of the poison was ejected in the 
repeated acts of vomiting. The hot-bath, mustard poultices, tur- 
pentine injections, and the like, were required to rouse the system. 

In overdoses any of the aconite preparations will act as nar- 
cotico-acrid poisons, setting up, in the first instance, more or less 



98 PREPARATIONS OF ACONITE. 

inflammation of the stomach and bows, with engorgement of the 
vessels of the brain and lungs. In all cases of poisoning by aco- 
nite, the stomach-pump, or a prompt emetic, should be employed 
to evacuate the stomach as soon as practicable. Then emollient 
mucilaginous drinks should be given ; also warm lemonade, or at 
least moderately tepid, to restore the lost tone of the stomach. 
If there be much and severe pain in the epigastric region, apply 
leeches or a blister to that spot. If the latter be employed, re- 
move the skin and apply half a grain of acetate of morphia, and 
repeat in an hour if necessary. 

In the London Lancet for July, 1856, we find a paper on the 
poison of aconite, by Dr. Headland, which embodies all that is 
important on that subject. After stating cases to show how 
small a dose of aconite, viz., fifteen drops, has nearly proved 
fatal, he closes with a brief summary of the treatment. As soon 
as the poisoning is suspected, a large quantity of animal charcoal 
should be administered. The aconite is quickly taken up and 
obstinately retained by this agent. Dr. H. thinks an emetic of 
zinc should be given after the charcoal, and not in the first in- 
stance. Then he advises the free use of brandy and ammonia. 

Two extracts of aconite are in use, viz., the common and the 
alcoholic. The former is made by expressing the fresh leaves 
moistened with water, having first bruised them in a mortar. 
The expressed juice is evaporated by a slow heat, constantly 
stirring it to avoid burning. The dose is one or two grains. 

The alcoholic extract is formed by evaporating a tincture made 
of a pound of aconite and a quart of alcohol. The dose is one- 
eighth of a grain, in pills made up with liquorice. It is also 
used for preparing an ointment by rubbing one part of extract 
with two of lard. 

The tinctures are numerous. One has been named already, 
of very great strength. The U. S. tincture is prepared from a 
pound of the root and twenty-four ounces of alcohol, digested 
during fourteen days. The dose is from three to five drops. 

Turnbull's tincture is made of one ounce of the powdered root 
and six ounces of alcohol, macerated two or three weeks. The 
dose is eight or ten drops three times a day, gradually increased 
until its effects are obvious. Few patients will bear a larger 
dose than twenty drops. 

The powdered leaves or root may be given in the dose of a 
grain or two grains, gradually increased. If well selected and 
properly dried, these will be full doses for an adult to begin with. 

The aconitina is thus obtained : — Two pounds of the best root 
are boiled with a gallon of rectified spirit in a retort with a re- 
ceiver attached, for one hour. Pour off the liquor and boil the 
residue again with another gallon of spirit, and with that recently 



ACUPUNCTURE. 99 

distilled. Let the same operation be repeated a third time. Ex- 
press the aconite, mix all the liquors, strain and distil. Evapo- 
rate the whole to the consistence of extract. Dissolve this in 
water and strain. Evaporate with gentle heat to a syrupy con- 
sistence. Add sulphuric acid diluted with water to take up the 
aconitina, and decompose the sulphate so formed by adding 
liquid ammonia. The precipitated alkaloid is to be boiled with 
animal charcoal in order to remove discoloration. Frequent 
washing and drying complete the process. 

The aconitina is prepared with a great deal of trouble, and 
after all is not worth our particular attention. It is quite too 
energetic to be a safe medicine in the profession at large. The 
fiftieth of a grain of the pure article nearly proved fatal to an 
elderly lady. 

The aconitic acid is named, but it would be a waste of time to 
speak of it particularly. 

We are well satisfied that the experience of physicians many 
years ago determined the true value of aconite and all its prepa- 
rations. We have very many articles that are decidedly superior 
and more safe ; and, although a very old medicine, we have no 
disposition to erase it from the old novelty list of infinitesimals. 

Acupunctuea. Acupuncture. — The literal import indicates 
the prick of a needle. It is an ancient mode for the cure of 
disease, which fell into very general disuse and was subsequently 
revived. The operation consists in the introduction of highly 
polished needles into any part of the body with a view to cure 
or relieve. A Dutch surgeon, by name Ten Rhyne, employed 
needles for the intent named more than one hundred and sixty 
years ago, and he restricted the remedy, as we now do, to chronic 
cases. 

The length of the needles depends on the depth of muscular 
tissue of the given part to be acted on, and they may vary from 
two to four inches. They should be perfectly smooth, of high 
polish, and furnished with a head or cap of sealing-wax to keep 
them from slipping in too far. Some physicians have employed 
needles of gold, platina, and silver, and to these there can be no 
objection save the cost. The common needle, however, if highly 
polished, will answer very well. Some employ a porte aiguille, 
or needle-holder, but such a contrivance is not at all necessary. 

The insertion of the needle is a very simple operation. The 
skin being made tense, the point of the needle is dipped in and 
passed down by a gentle turning and downward motion. The 
number of needles to be inserted depends on the part affected, 
the extent of disease, &c. It is better to have too many than too 
few, and they should be pretty close together. No fixed rule 
can be stated for the length of time the needles should remain in 



100 hog's lard. 

the part. It may vary from five minutes to two hours, and 
occasionally may extend to three days. The operation is some- 
times painful, and sometimes almost free of uneasy sensation. 
The lightest change in the position of the needles will often 
materially alter the effect. The slightest extraction or the least 
forcing in will sometimes greatly lessen the uneasy feelings. 
The operation that gives the least pain often proves to be the 
most salutary. Some realize a kind of electric shock when 
needles are inserted ; others have a tremulous motion in the 
muscular fibres. If good is to result at all from the operation it 
may be looked for soon. This is the general rule. 

The extraction of common needles usually gives more pain 
than their insertion, especially if they penetrated deep and re- 
mained in the part a long while. This is accounted for by the 
rusting or oxidation of the surface, which presents many rough 
points that give pain as the needle is drawn out. To this disad- 
vantage needles of gold or silver or platina are not liable. In 
order to extract the needles, rotate gently, pressing slightly on 
the surrounding skin, and making a gentle extractive effort at 
the same time. The remedy is held to be perfectly safe. 

The modus operandi of acupuncture is not entirely understood. 
It is probably neither more nor less than the establishing of a new 
nervous impression which is more powerful than the diseased one 
and withal more salutary. Some have imagined that the result 
depended on the degree of oxidation of the needles, but it has 
happened frequently that most benign consequences followed the 
use of needles that did not rust. Some have thought that the 
entire operation was a kind of galvanic process, and that the 
agent was electricity. Doubtless a concentration of nervous 
power attends the operation, and this may contribute to the salu- 
tary result. 

Grout, rheumatism, convulsive diseases, amaurosis, chronic 
ophthalmia, anasarca, tic douloureux, and many other affections, 
have been successfully treated by this mode of cure. Electricity 
and galvanism have been conjoined with acupuncture, and hence 
the terms electro-puncture and galvano-puncture. The latter 
is reported to have recovered the speech of a person who had 
been dumb for the space of twenty-three years, as we learn 
from the Phila. Med. Examiner of May, 1848. For further 
information touching electro and galvano-puncture, see London 
Lancet, July 29, 1843, and Bell's Bulletin of Med. Science, 
August, 1843. 

Adeps Suillje. Hog's Lard. — This needs no description. 
For all medicinal purposes the fresher and sweeter it is the bet- 
ter. As usually sold it contains more or less salt, which unfits it 
for various therapeutic uses. To get rid of this foreign matter 



ADULTERATION OF MEDICINES. 101 

pour boiling water on the mass and stir it well ; the water will 
dissolve all the salt and the pure lard will float on the surface. 

Lard is employed in the formation of ointments and plasters, 
and occasionally to make clysters. It has been successfully tried 
in the treatment of itch. The whole surface being well coated with 
lard, the insect which causes the disease is destroyed speedily. 
Whatever the theory may be worth, the fact is of some conse- 
quence. Some one has truly said that a scruple of real facts is 
worth more than a ton of theories. 

That very troublesome disease, erysipelas, has been happily 
treated by inunction with lard. The intolerable itching is thus 
speedily controlled, and all the symptoms mitigated. The remedy 
has been supposed to act chiefly by excluding the external air. 

The celebrated ointment of Devergie for the cure of chilblains 
consists chiefly of lard. It is said to be the best remedy for this 
disease when associated with actual ulceration, and is to be applied 
night and morning, after careful ablution with tepid soapsuds. 
The formula is as follows : — 

R. — Adip. suilla3 ^i; 

Goulard, ext. xij drops ; 

Pulv. opii gr. iij ; 

Creosot. x drops. 
Mix. 

Dr. Schneeman, physician to the King of Hanover, has pub- 
lished a pamphlet on the efficacy of inunction in the treatment of 
scarlatina. An abstract of this work may be seen in the London 
Lancet for January, 1850, which the reader may consult for 
fuller details. In place of lard, however, Dr. S. employs a piece 
of fat bacon, and rubs it cold into the whole surface, so as com- 
pletely to anoint the entire body. This operation is to be done 
daily for ten days or two weeks. It is said to relieve the itching 
and burning of the skin, to allay soreness of the throat, to pre- 
vent infection, to make desquamation more easy, and to lessen 
the risk of dropsy. In a children's hospital, at Vienna, the prac- 
tice has long been in use. It merits a trial on a large scale in 
this country. 

In the Southern Journal of Medicine and Pharmacy, Dr. 
Pritchard reports very marked success in the use of hog's lard to 
remove obstinate constipation. Calomel, croton oil, Epsom salts, 
injections, blisters, &c, were tried to no purpose. Half a pint 
of lard was taken and retained, and as much more on the next 
day. The abdomen became softer, and the patient was more 
comfortable. Another half-pint was given and retained without 
difficulty. Soon after this there was a copious feculent evacua- 
tion, and the man quickly recovered. 

Adulteration of Medicines. — The importance of pure and 



102 AGRICULTURE. 

genuine articles of medicine is next in magnitude only to the 
right knowledge for their due administration. Those who will 
consult the work of Beck on this subject will learn the extent to 
which the practice of adulterating has been carried in this country. 
In fact, there is scarcely an article worth a name in the list that 
has not been fraudulently compounded. And as it is not possible 
for the practitioner to devote the requisite time to the examina- 
tion of individual articles, our best advice is to select the apothe- 
cary in a town or city who has the highest reputation for honesty, 
as well as knowledge of his business, and to deal regularly with 
an individual of that stamp. Touching the prices for medicines, 
let me say, as the result of some experience and observation, that 
it is good policy to pay high charges rather than to seek for what 
are called bargains. The best quality of medicine will ever com- 
mand the best prices, and it would be strange if it were other- 
wise. The judicious physician will send his orders for small 
rather than for large quantities at once. Three or four supplies 
in the course of a year, from a good house, will secure to him all 
that he can desire on the score of really good articles of Materia 
Medica. 

Dr. Bailey, a special examiner of drugs, &c. &c. under a late 
law of Congress, rejected, at the port of New York, ninety 
thousand pounds of articles imported into that city, such as 
rhubarb, opium, Peruvian bark, jalap, iodine, croton oil, &c. &c, 
in about six months. Not less than thirty-four thousand pounds 
of spurious and worthless cinchona bark were subjected to Dr. 
B.'s inspection, and he gives the most satisfactory reason for re- 
jecting the whole. The article was found to be almost entirely 
void of the natural alkaloids of the true barks, and therefore 
to possess no valuable antiperiodic quality. These spurious barks 
cost about six cents per pound, delivered in New York, while the 
genuine bark cannot be furnished for less than eighty cents. 

I have quoted from the remarks of Dr. Bailey on Peruvian 
bark for the special reason that no article is so largely consumed 
in the management of our diseases as the sulphate of quinine. 
But the researches of Dr. B. prove conclusively that opium and 
iodine, and other articles regarded as indispensable, are also sub- 
jects of the most scandalous frauds. 

We cannot but rejoice that so efficient an officer has been em- 
ployed in this important task, and fondly hope that others 
equally competent may be assigned speedily to the same laudable 
investigation. 

Agriculture. — We feel no hesitation in placing this item 
here as a strictly therapeutic agent. We have no objection to be 
called heterodoxical for saying that we are quite willing to cure 
the sick without a dose of medicine. That this end can be at- 



ALCOHOL. 103 

tained, sometimes, better by working moderately on a farm, or in 
the lighter toil of a vegetable or flower garden, we know by ex- 
perience. Shattered in our nervous system severely, in 1854, by 
a terrible neuralgic seizure in the left hip and down to the toes, 
we almost despaired of ever being able to display anything like 
manly physical energy. We eschewed physic almost entirely, 
and made an experiment with horticulture. The trial worked 
most happily. And if any one would like to see an exemplifi- 
cation in one person of Headland's classification, copied into 
our Introduction, he may find it in agriculture and horticulture 
employed for the cure of neuralgic disease in a patient over fifty 
years of age. That this remedy is hcematic, or capable of im- 
proving the blood, I am quite sure. That it is neurotic, or suited 
to allay all nervous derangement, is not a questionable point with 
me. And as an eliminative, carrying morbid matter out of the 
system, it is equally efficient. 

Now it is not pretended that agriculture or horticulture is an 
infallible remedy. But it is, beyond doubt, too much neglected. 
Let it be tried, moderately at first, so as not to fatigue, and never 
be overdone so as to exhaust the vital force. 

Alcohol. — This term is of Arabic origin, and was formerly 
applied to any pure essence. The more common use of the word 
refers to pure intoxicating spirit. The ready combustibility of 
alcohol is well known, and the effect of combustion is to convert 
it into water and carbonic acid. It is one of the fluids that is 
miscible with water in all proportions. It is exceedingly volatile, 
and the purer it is the more obvious is this property. We are 
not aware of more than a single instance in which it was com- 
pletely frozen, and hence its importance in the construction of 
thermometers to measure very low temperatures. It is the well- 
known solvent of pure resins and of articles that contain more or 
less resin, just in proportion as this ingredient preponderates, and 
hence its relation to tinctures. When pure it is very much lighter 
than water. 

Alcohol, as such, has never yet been found as a natural, ori- 
ginal product. It is always formed by art, and hence is the fruit 
of man's ingenuity, and never a direct gift of Providence. It 
results from the derangement of the elementary principles of 
vegetable matter and the resulting combinations that ensue ; 
hence all sorts of vegetable matter can be made to yield it on 
this principle. All wines, domestic or foreign, contain alcohol ; 
and Mr. Brande justly remarked that the strength of wine is, 
truly, alcohol. 

It has been erroneously said, more than once, that alcohol is 
the result of distillation ; whereas this process simply separates it 
from the fluid mass after fermentation has developed this new 



104 ALCOHOL NOT NECESSARY IN A STATE OF HEALTH. 

principle. The alcohol being lighter than the balance of the 
liquid, is driven over by the heat employed in the process of dis- 
tillation. The term absolute alcohol means the pure unadul- 
terated article. Alcohol fortius is known also by the term spiri- 
tus vini rectificatus. Proof spirit is alcohol more or less diluted 
with water, and sometimes called spiritus tenuior. 

On account of its active solvent power the books abound with 
tinctures, and there has been too great a willingness to exhibit 
them. But, inasmuch as a large majority of the sots have be'en 
made so by the doctors, through the agency of alcoholic medi- 
cines, it is the duty of the profession to correct the evil as speedily 
as the nature of the case will allow. 

The introduction of the sulphate of quinine into medical prac- 
tice has done a good deal to lessen the consumption of alcoholic 
fluids under the name of medicine. Forty years ago, very many 
hogsheads of brandy and wine and kindred articles were made 
vehicles of the administration of Peruvian bark in the treatment 
of intermittents. A fondness for strong drink was thus established 
so deeply in the systems of thousands as to put all the efforts of 
philanthropy to eradicate it to defiance. And though we may, 
and do rejoice, that nobody, except in very peculiar cases, thinks 
of curing ague and fever with brandy now, there is still room for 
reformation. Tinctures are resorted to needlessly in cases which 
could be managed quite as well, and it may be far better, by 
powders, pills, infusions, extracts, and aqueous mixtures. 

In a case of emergency, where life is at hazard, the physician 
may and should employ any remedy within his reach. But, in 
regular practice, under ordinary circumstances, when he can 
select his means, he is bound to eschew all remedies that have a 
tendency to fix in the system a ruinous habit that may be lasting 
as life. The present state of society demands an abridgement 
(if not the exclusion) of all alcoholic medicines, and it is in the 
power of every physician to do something in this cause. Most 
assuredly a wise man will never administer anything like alcohol 
to a patient who has been intemperate, unless he cannot avoid so 
doing, as in a case of extremity may happen occasionally. As 
a general rule, there is no need for such administration, while the 
hazard is immense. 

The question is often asked, even in this enlightened day, " Is 
alcohol, in any form, necessary to any man in full health?" The 
reply dictated by the soundest philosophy and common sense is, 
uncompromisingly, no. Captain Boss's history of his second 
voyage to find the northwest passage proves, beyond the possi- 
bility of mistake, that alcohol is not only not necessary in the 
coldest latitudes, but that its agency is decidedly pernicious. 
Those of his crew who suffered most in the regions of perpetual 



EXTERNAL USE THE SAFEST. 105 

ice were those who could not be prevailed upon to abstain from 
the use of strong drink. The mercury in the thermometers fell 
so low that it was actually frozen, and yet the most efficient 
sailors were those who drank no beverage stronger than water. 
The temperance ships that have visited all parts of the world 
and passed through all latitudes have proved conclusively that 
neither intense heat nor severe cold can be the better endured by 
the aid of stimulationg liquors. The experience of hundreds of 
temperance physicians, who never taste alcohol in any shape, is to 
the same point. Monro, on the Diseases of Soldiers; Mosely, 
on the Diseases of Hot Climates ; Jackson, Marshall, and many 
other distinguished physicians, bear corresponding testimony. 
They assure us that coffee, lemonade, vinegar and water, and the 
like, are far better for soldiers in hot climates than any sort of 
intoxicating drink. 

Can a man abandon the excessive use of alcoholic potations at 
once without injury? How frequently has this query been pro- 
pounded ! just as if it had not been responded to by more than a 
thousand living proofs. A fixed resolution to forego at once and 
forever the use of strong drink has been, and therefore may be 
again, potent enough to secure the result. Men adjudged by 
their neighbors to be entirely ruined, almost outcasts from society, 
have stopped in their career of intemperance, and ceased to taste 
the poison, merely because they had publicly taken an oath to 
abstain entirely for a fixed period. 

When a physician is consulted in such cases, under the appre- 
hension that bad consequences may follow, for a time, at least, he 
should direct the free use of ginger, cinnamon, cloves, in the form 
of infusion ; soups, with plenty of Cayenne pepper, and the like. 
The milk of assafcetida will also be very proper, and occasionally 
some of the bitter vegetable infusions. 

The safest use of alcohol is for external medication, in the 
form of fomentations, frictions, &c. ; but even when thus em- 
ployed the alcohol should be combined with such substances as 
will forbid its use internally by those who have a fondness for it. 
I was once summoned to see a nurse who was supposed to be 
poisoned. There was no kind of intoxicating drink to which she 
could have access save a large bottle full of old whisky in which 
cocculus indicus had been digested for several months. This 
bottle had been placed on an upper shelf in a closet but little in 
use, and the liquor was applied in proper season to the purpose 
of killing bed-bugs. The nurse found the hid treasure and ex- 
hausted it. Her last dose was unusually large; it contained the 
dregs of the berry, and the effect was a narcotic poisoning which 
called for free vomiting and local irritants to subdue it. 

Inasmuch as all, or nearly all, the brandy, gin, whisky, rum, 

8 



106 USES OF ALCOHOL. 

and wines sold in the country are adulterations, compounded in 
part of deleterious agents, the physician who thinks he cannot 
altogether dispense with alcoholic liquor should purchase the 
purest alcohol that is on sale. The only efficient agent in any of 
the liquids named is alcohol, and hence the propriety of procuring 
this in a pure form and diluting it as may be desirable. 

Dr. Todd has published the history of eighteen cases of low 
typhus fever treated by the free exhibition of brandy ', of which 
about a half-ounce was given every half hour, night and day. 
It is proper to add, however, that the patients took, also, chloric 
ether, carbonate of ammonia, and beef tea. Blisters were also 
employed. The ages of the patients varied from twenty to 
seventy. Only one case terminated fatally. In the other cases 
the pulse fell from one hundred and thirty to ninety in less than 
four days, the skin resuming also its wonted condition. — Braith- 
waite, part xxviii. p. 20. 

The external use of alcohol is employed with a view to its 
rubefacient and refrigerant effects. To insure the former, soak 
a compress in the alcoholic liquor and confine it by means of a 
bandage, so as to retard evaporation. If strong alcohol be thus 
applied, it will not only redden the skin but sometimes actually 
vesicate. We get a refrigerant result when alcohol is applied 
to a part laboring under inflammation, without either compress 
or bandage. Evaporation goes on rapidly, the heat of the part 
» is thus carried off, and the patient is conscious of a reduction of 
temperature. 

In vol. vi. of Duncan's Medical Commentaries, the injection 
of diluted alcohol is highly praised for the speedy and safe cure 
of gonorrhoea. An ounce of the pure spirit is added to six 
ounces of water, or more, as circumstances may demand. The 
injection should induce some smarting pain for a few minutes. 
It should be thrown into the urethra every three hours, or oftener, 
until the discharge is checked, which will require about a day ; 
after that the injection is employed less frequently. It is 
affirmed that this treatment will cure the disease in nine times 
out of ten. The facts and opinions of the writer make it evi- 
dent that the treatment is really abortive, very much like the 
action of nitrate of silver. 

Alcohol, under all its varied names, has been frequently em- 
ployed for the cure of burns and scalds, and in the way of 
fomentation for the relief of local pains. The employment in 
all these instances calls for sound judgment and wise discretion, 
to adapt the remedy to the existing circumstances. 

The very severe pain of gout in the extremities has been 
promptly relieved by the application of pure spirits of wine. 
Dr. Goolden is in the habit of using it in private and in hospital 



POISONOUS ACTION OF ALCOHOL. 107 

practice. The editor of the Times says he witnessed its almost 
immediate efficacy in a patient in St. Thomas's hospital, in whom 
the pains of the foot were agonizing. It is supposed that the 
alcohol acts by absorption more than by mere evaporation. The 
mode of application is by a piece of lint saturated with the spirit, 
laid on the part and then covered with oiled silk. — Med. Times, 
Nov. 12, 1854. 

Internally exhibited, alcohol is decidedly a stimulant, and 
occasionally a very valuable one. Thus, in deep and sudden 
prostration caused by severe purgation, strong milk punch is 
speedily restorative. The discharge is checked, and the system 
invigorated, and all this independently of any sort of intoxi- 
cating effect, even though a pint of brandy be swallowed in the 
course of four or five hours. On the same principle, too, alcohol 
has been useful, in the form of brandy, in exhausting uterine he- 
morrhage that threatened the extinction of vitality. 

When an individual has been poisoned by alcoholic drink, he 
should be roused, if practicable, by the use of a prompt emetic. 
If the stomach-pump can be employed it will serve to empty the 
stomach effectually. Sometimes, however, the jaws are fixed, 
and it is impossible to open the mouth so as to introduce medicine 
or anything else. In such cases I have succeeded by laying a 
poultice of tobacco leaf, soaked in hot water, on the epigastric 
region. Should the insensibility still remain, the free use of the 
cold dash* on the naked surface will sometimes be effectual. 
Flagellation, cowhage, and the actual cautery, have all been ap- 
plied to the skin with good result. It is said that a teaspoonful 
of aqua ammonia will speedily put a period to the symptoms of 
alcoholic poisoning. If there be obvious and alarming conges- 
tion of the brain, and the subject be florid and plethoric, it will 
be proper to open a vein and detract from twelve to twenty 
ounces of blood. 

Notwithstanding all that has been said, and well said on this 
subject, there are some persons who deny that alcohol and 

* During my residence in Louisville, an old inebriate, who was seldom if ever 
seen in a state of absolute sobriety, undertook to cure a very noisy street drunk- 
ard, who planted himself near to the old gentleman's front door, ever and anon 
vociferating at the top of his voice and so gathering a crowd of noisy boys. He 
urged the half-insane sot to go away, to no purpose. Then his black man was 
ordered to bring two buckets full of cold water just pumped out of a deep well. 
It was midsummer, and the noisy fellow was in his shirt sleeves. In an instant 
both buckets were emptied into the man's face with all the violence that muscle 
could impart. After the first sense of semi-suffocation was over the ducked sot 
was on his feet, cursing most furiously, but evidently almost if not entirely 
sober. "Oh hush!" said the administrator ; " it would have cost you twenty-five 
cents for not half so good a bath at Caspar? s Bath-house." The cure was prompt 
and effectual. I am not sure that the modus operandi lies within any branch of 
Dr. Headland's classification. 



108 ALCOHOL A POISON. 

strong drinks are poisons ; and we feel disposed, therefore, to 
present what we regard as the pith of the evidence on this 
point. Is alcohol, in all the forms of its beverage-use, a poison f 

In attempting to decide this matter let it be borne in mind 
that if we can show, on good authority, that alcoholic drinks do 
produce results similar to those which mark the operation of 
acknowledged poisons, our end is gained. If, in addition, its 
deleterious influence can be shown to be greater than that of 
common poisons, the cause we advocate will be found to have 
acquired strength. 

Christison, Orfila, Sedillot, Beck, and all authors of note on 
toxicology, class alcohol with the narcotico-acrid poisons. Not 
only pure alcohol, but its varied forms of mixture in common use 
are all shown to be decidedly deleterious to the human system. 
The above, and many other writers, confirm the declarations of 
Rush and Trotter, made fifty years ago. The authority of these 
two distinguished men is entitled to great respect. 

As it is also to our purpose, we quote the following remarks 
from the celebrated work of Dr. A. T. Thompson, on Materia 
Medica and Therapeutics, page 207: — "It may be reasonably 
asked, however, of what benefit is even the temperate use of 
ardent spirits to a healthful individual who requires no additional 
excitement either of his mental or corporeal energies ? To this 
question no satisfactory reply can be offered ; and, notwithstand- 
ing the universal propensity of the human species for intoxication, 
and the ingenuity exercised in obtaining means to effect it, yet 
ardent spirits can be justly regarded in no other point of view 
than as either a medicine or a poison." Combe on Digestion, 
pages 280 and 285, is to the same point substantially. 

Orfila, in his Greneral Toxicology, vol. ii., mentions the case of 
a soldier who died instantly after drinking eight pints of brandy 
for a wager. Christison has the case of a man who stole a bot- 
tle of whisky, and, fearing detection, drank the whole of it. He 
died in four hours with symptoms of pure coma. 

Very recently I had intelligence of a lad ten years of age 
who secretly drank from a whisky bottle, in imitation of his 
father, who was at work in the field. The sudden silence of the 
boy attracted the notice of the parent, when a wild, fixed gaze 
was discovered, that denoted something wrong. The father 
called the boy by name but in vain, and in less than an hour he 
was dead. How much of the liquor he drank is not known. 
Many similar facts could be adduced if necessary. 

Other cases are detailed, in which the fatal results were 
more slowly developed, being preceded by delirium, insensi- 
bility, spasms, convulsions, apoplexy, &c. &c. These diversified 
operations of the poison — all, however, tending to the same sad 



EFFECTS OF ALCOHOL. 109 

issue — are very similar to what is often noticed in the action of 
opium, arsenic, and the like. These latter given in large doses 
kill speedily; if the dose be smaller the effect is procrastinated 
to hours, or days, or even months, as I have known in reference 
to the poison of arsenic, and as will be more particularly noticed 
hereafter. If arsenic fail to spend the whole of its poisonous 
energy on the stomach and bowels, and should happen to im- 
press morbidly the nervous system, we discover paralysis of the 
extremities, which, extending its sphere, at length pervades the 
whole system, and the victim perishes miserably after months 
of severe suffering. Others in the same family may have died 
in a few hours from the same cause, owing to the violent action 
of the poison on the primae viae. But would any one doubt that 
the results in all the cases flowed, as a natural consequence, from 
the poison of arsenic ? The same reasoning is equally applicable 
to all the forms of alcoholic drink. 

The following cases will serve to illustrate still further the 
effects of alcohol on the human system. They may be found in 
the London Lancet, vol. i. for 1839-40. 

" A man who had previously enjoyed very good health swal- 
lowed by mistake about eight ounces of alcohol 50° above proof. 
He dropped instantly on the floor in a state of insensibility. In 
a few minutes a medical man saw him, and found him to be ex- 
ceedingly cold, with the respiration calm, the pulse nearly gone, 
and lips blue. His wife refused to have the stomach emptied, 
but gave him some purgative pills. He continued in the cold 
insensible state for about eleven hours, at the expiration of 
which he opened his eyes, gazed around, and inquired how he 
got home from work. During the eleven hours he passed no 
urine or feces ; but on regaining sensibility the bowels were 
moved, the evacuations being pitch-like. He went to work on 
the following day, and remained apparently well for about three 
weeks." 

Here we see how very rapid and violent is the action of a full 
dose of strong alcohol. We learn, also, that although the pa- 
tient seemed to recover, the foundation for serious and perhaps 
incurable disease was thus laid. 

"At the end of the three weeks referred to he was so unwell 
as to apply to an apothecary, who gave him an emetic and a ca- 
thartic, after whose operation Dr. Bird found him with pupils 
widely dilated, with pale countenance, pulse one hundred and 
twenty, appetite good, and inclined to be drowsy. There was 
no paralysis, and yet he was not able to follow his trade. Dr. 
Bird thought the case bore some analogy to delirium tremens, 
and a variety of treatment was resorted to, but without effect. 
Up to the date of the report, about five months, the man con- 



110 EFFECTS OF ALCOHOL. 

tinued to be unwell. The points of interest in the case were, 
1. The sudden effect of the alcohol. 2. The apparent recovery 
at the end of eleven hours, and .continuance of that state for 
three weeks. 3. The obvious decline of health after that date, 
and the apparently incurable condition of the patient." 

In the same report (Westminster Medical Society, 1839) we 
have the case of a lad, aged sixteen, who for a wager drank a 
pint of gin. He shivered and became insensible, and was so 
found by the surgeon who arrived very soon after the accident. 
The pupils were dilated, there was no pulse, and the extremities 
were cold. The stomach-pump was applied and a large quan- 
tity of spirit removed. The boy remained insensible for twelve 
hours, and then slowly recovered. From that period, however, 
he exhibited marks of feebleness and disease, and was a burden 
to his family. 

But the deleterious influence of alcohol goes even farther. It 
reaches the very deepest recesses of the moral as well as the 
physical nature ; poisons not only the fountains of life, but the 
springs of intelligence; and transforms the man into a non- 
descript, to compare which with the harmless beast would be an 
unmerited degradation of the latter. 

Plutarch's Morals, published in 1718, at London, has these 
remarks: — "They usually prove wine-bibbers and drunkards, 
whose parents begot them when they were drunk; wherefore 
Diogenes said to a stripling, somewhat crack-brained and half- 
witted, * Surely, young man, thy father begot thee when he was 
drunk.' ' And Burton, in his celebrated work called Anatomy 
of Melancholy, remarks, — "If a drunken man gets a child, it 
will never, likely, have a good brain." The reasoning connected 
with these reflections is too copious for our present purpose, but 
suffices to show that alohol is the most pervasive of all poisons 
and the most ruinous by far to society. 

Orfila has demonstrated that if alcohol be injected into the 
cellular tissue its poisonous quality is as plainly developed as 
when it is passed into the stomach. Injected into the cavity of 
the chest it appears to be equally energetic. 

Some have supposed that alcohol poisons by its influence on 
the brain through the medium of the nerves, without first enter- 
ing the blood. Others think that it actually finds its way to the 
circulating mass very speedily, although it is not assimilated with 
the vital fluids. Every one knows that the breath is soon impreg- 
nated with the odor of spirits, and that the smell remains for a 
considerable length of time. 

We have referred to the diversified operation of alcohol, de- 
pendent on the strength of the fluid, the habits, health, idiosyn- 
cracies, &c. of the patient, all which may exert a modifying influ- 



EFFECTS OF ALCOHOL. Ill 

ence. Hence the well-known fact that some men may be intoxi- 
cated with a single glass of brandy and water, while others will be 
scarcely affected (not obviously at any rate) by ten times as much. 

Superadded to the appropriate effects of this poison is the 
agency of season in insuring the fatal result. Thus, in very 
cold weather the intoxicated man may perish by the conjoined 
influence of reduced temperature sooner than under more favor- 
able circumstances. He is exposed, also, to other accidents, 
which under different contingencies might be tolerated, but 
which tend to aggravate the condition resulting from the alco- 
holic poison and to accelerate death. 

Beaupre, in his excellent work on Cold, tells of a fete given 
under Potemkins's administration at Petersburg, in Russia, by a 
farmer-general of distilled spirits, in which from fifteen to eighteen 
hundred persons, who committed too great excesses in spirituous 
drink, perished miserably from cold in the streets and squares of 
that capital. (Page 130.) And, further, that the soldiers who 
got drunk on the retreat from Moscow fell asleep, in spite of all 
efforts to rouse them ; the cold, and narcotic effects of the alcohol 
overpowered them. 

One of the most frightful effects of the poison of alcohol is the 
disease known to physicians by the name of delirium tremens, 
which frequently terminates in death. Indurations of the liver, 
jaundice, dropsy, inflammation of the kidneys, scirrhous pylorus, 
a thickened and callous state of the whole stomach, contraction 
of that organ, aneurism of the heart and great blood-vessels, 
hemorrhage from the lungs, mania, epilepsy, spontaneous com- 
bustion, all result from the deleterious action of alcohol on the 
animal economy. It impairs the integrity of every living fibre, 
and infuses its pestiferous influence into every atom of the organ- 
ized fabric. 

The morbid appearances induced by alcohol, as developed by 
post-mortem examinations, are exceedingly various, as might be 
expected. The mucous coat of the stomach is found inflamed 
more or less, or highly congested, or ulcerated, or in a scirrhous 
state, and sometimes actually cancerous. These results depend 
partly upon the length of time the victim has been addicted to 
the use of strong drink and partly on constitutional peculiarities. 
In some cases the stomach presents no unusual appearance ; and 
this is especially true where the quantity taken is so large as to 
kill in a few minutes. The narcotic influence is exerted on the 
brain, from the stomach, without sensibly impressing the latter. 
The brain is often found to exhibit proofs of extravasation, yet 
this is not a uniform occurrence. Where a predisposition to con- 
gestion of the brain previously existed we would expect to meet 
with such extravasations more or less extensively. 



112 EFFECTS OF ALCOHOL. 

On opening the stomach of a victim to this poison, you may 
expect to find some of the liquor, if the quantity taken was large 
and death speedily followed. In such cases the poison could not 
all be absorbed during life, nor could it pass off by reason of 
volatility, unless the examination was postponed too long. Gene- 
rally, the strong smell of the liquor will indicate its quality, and 
with other previous information may decide that point satisfac- 
torily. If there be any doubt that an alcoholic liquor is present 
in such a case, collect the fluid contents of the stomach and sub- 
ject them to distillation from the vapor bath. The product will 
be a mixture of water and alcohol, from which the former can be 
detached by frequent agitation with perfectly dry carbonate of 
potash. This will leave the alcohol of sufficient purity to dissi- 
pate all doubt as to its nature. 

Dr. Christison doubts the correctness of reported facts of di- 
luted alcohol found in the ventricles of the brain, although asserted 
by several very respectable physicians in different parts of the 
world. But his reasons for being skeptical do not carry with 
them, to my mind, the slightest force. He might as well, at this 
time of day, set aside the conceded position that spontaneous 
combustion has been the fate of more than a hundred drunkards, 
and these scattered over the globe, by his notion that the liquor 
must coagulate the blood if so inflammable a fluid, as is alleged, 
pervades the whole body. But to me it would appear much more 
strange that some few, at least, of the great army of drunkards 
should not have every living fibre so thoroughly saturated with 
that which for years has been their principal meat and drink as 
to be susceptible of instantaneous combustion, in the manner so 
often heralded in the newspapers and scientific journals. 

What has been said, thus far, of alcoholic drinks was predi- 
cated on the notion of their purity, or rather their freedom from 
adulteration. Under the most favorable circumstances we have 
seen something of their dire effects; but how must these be 
aggravated by the scandalous tricks of manufacturers, that are 
now as notorious as the use of the article? Brandy, rum, gin, 
wines, beer, porter, &c, are all the subject of constant frauds, 
and the adulterations are made a matter of scientific study. The 
most acrid vegetable and mineral substances, as copperas, alum, 
cocculus indicus, cherry laurel water, and many other poisonous 
matters, known and concealed, are employed to convert common 
whisky into real French brandy, Holland gin, Jamaica spirits, 
&c. &c. So by various admixtures unsaleable wines are con- 
verted into genuine Oporto to such an extent that, according to 
the best statistics, nearly twenty times more casks of Port wine 
are on sale in Great Britain annually than are manufactured at 
Oporto. The same fraud is also perpetrated with Madeira, only 



MATERIA ALIMENTARIA. 113 

to a much greater extent, so that probably not one in every 
hundred casks called by that name and sold in this country con- 
tains a drop of the genuine wine. The following extract from 
an official document speaks for itself : — "Vast quantities of wine, 
in imitation of the produce of all the wine-growing countries, are 
manufactured at Cette and Marseilles, and sent by collusion to 
Madeira, and thence, after being branded with the usual marks 
of the genuine Madeira vintage, are re-shipped to this country. 
And frauds to the same extent and in the same way are perpe- 
trated in the manufacture of Port and other wines. A single 
fact may give some idea of the extent to which these frauds are 
carried on in England. According to the custom-house books 
of Oporto, one hundred and thirty-five pipes and twenty hogs- 
heads of wine were shipped to Guernsey. The same year there 
were sent from Guernsey and landed at the London docks two 
thousand five hundred and forty-five pipes and one hundred and 
sixty-two hogsheads, all reputed to be genuine Port ! So largely 
is this nefarious traffic carried on that one man in France has 
been known to ship to this country one hundred thousand bottles 
of wine a year, professedly Champagne, but which was not the 
produce of the Champagne districts. Genuine Champagne is 
never sent out of France for less than about seven dollars per 
dozen. But that which affects to bear the marks of the genuine 
is a drug often at two dollars."* 

Alimentaria Materia. — The old division of Materia Medica 
embraced two grand features, viz., Materia Medica, or things 
purely medicinal, and Materia Alimentaria, including all the 
articles regarded as alimentary or dietetic. We have no desire 
to enlarge on this latter feature. It is proper to say, however, 
that every kind of food that is capable of assisting the processes 
of animal respiration and animal nutrition is entitled to the ap- 
pellation of alimentary. It was once affirmed that gum Arabic 
did not come under this category, although it is an historical fact 
that a very large body of Arabs subsisted on it, and on such 
water as they could procure, for more than two months. So, 
more recently, it has been contended that coffee and tea, though 
in such universal use, were not alimentary, because they did not 
contribute to sustain the animal vigor. But if Liebig has proved 
anything at all he has conclusively shown that gum is one of the 
elements of respiration, and therefore aids that process materially. 
And it is made equally plain by the analyses of Liebig and 
Pfaff, Jobst and Martius, that coffee and tea are highly nitro- 
genized compounds, each containing in every hundred parts 

* A wealthy citizen of Philadelphia, who has been almost half a century in 
the liquor business, was asked by a friend how much of the so-called French 
brandy sold in this city was genuine. The reply was, ''Not more than one-tenth.'''' 



114 USES OF GARLIC. 

about twenty-nine of nitrogen, fifty of carbon, five of hydrogen, 
and sixteen of oxygen, and therefore decidedly alimentary. 

We are well aware that peculiarities of constitution and the 
influence of habit may exert a very perceptible control on the 
effect of certain articles of food. Still the general law holds 
good that diet, to be truly alimentary, must conform very much 
to the elementary structure of the animal tissues and the nature 
of the more important functions. The common sense of man- 
kind in all countries seems to have carried out this grand prin- 
ciple instinctively as a law of Nature, of which Liebig's disco- 
veries are only humble interpreters. If the present work were 
a treatise on Food, it would be gratifying to pursue the subject 
into its details ; but this is not our purpose. 

Allium Sativum. Q-arlic. — This is too well known to need 
a description. It is one of the articles that serve to illustrate 
the power of habit. The English universally detest it. The 
Russians, Poles, Spaniards, Portuguese, the Jews everywhere, 
relish it in every form. The active properties reside in a volatile 
oil, easily separated by heat. So penetrating is the odor of 
garlic, that if a poultice be applied to the soles of the feet the 
odor will exhale from the lungs and the taste will be perceptible. 
The flesh of fowls, their eggs, as well as milk and butter, are 
liable to be impregnated by it. 

Dioscorides advised garlic as a remedy for tapeworm, for veno- 
mous bites, coughs, obstructions of the urine, &c. Celsus em- 
ployed it to prevent the paroxysms of ague. Sydenham used it 
as a rubefacient to the soles of the feet in persons laboring under 
confluent smallpox. 

One of the oldest uses of garlic is to the spine of young chil- 
dren affected with hooping-cough. The expressed juice mixed 
with sweet oil, or alone, has been employed for this end, and the 
practice obtains now in some parts of our country. Garlic is 
also an ancient remedy for deafness, and it certainly has a de- 
cided advantage over many costly nostrums. It may be service- 
able, and probably will do no harm. 

A syrup of garlic, made by adding white sugar to the juice of 
garlic and gently simmering the mixture, is often beneficial to 
old asthmatics, by promoting expectoration and removing stricture 
of the chest. 

The very worst mode of administering garlic, though quite 
popular in some sections of the country, is in gin and whisky, 
for the cure of worms. A much safer and better practice is to 
rub the garlic to a pulp with as much sugar as can be incorpo- 
rated with it. The mixture is readily taken by young children, 
and is frequently efficacious. 

The diuretic property of garlic is manifest by its internal and 






ALLOPATHY — ALOES. 115 

external use. A few cloves bruised with a little hot vinegar and 
laid on the pubic region will generally excite a discharge of urine 
in young children. The expedient is simple and efficient. 

A clove of garlic cut in two pieces and the fresh surface ap- 
plied to a spot stung by a wasp or bee will promptly allay the 
irritation and abate the pain. It acts very much as liquid am- 
monia when used for the same end. 

The dose of garlic juice for an adult is a tablespoonful, which 
may be repeated frequently, alone or mixed with syrup. In ex- 
cessive portions it induces gastric irritation, hemorrhoids, head- 
ache, fever, &c. 

From what has been said it is obvious that the therapeutic 
properties of garlic are various, viz., stimulant, expectorant, tonic, 
diuretic, anthelmintic, rubefacient. 

Allopathy. From alios and pathos, other disease. — This 
term has been regarded as referring to any medicinal agent 
capable of curing a diseased action by setting up another of a 
different kind. In this view of the term, the infinitesimals, 
usually styled homoeopathic doctors, designate the regular prac- 
titioners by the title of allopaths, or allopathic physicians. The 
title is exceedingly inappropriate, because it covers but a small 
portion of the ground occupied by the regular practice. Every 
well-instructed physician does much more than attempt to cure 
by counter-irritation, or by setting up one action to remove 
another. Very frequently we give emetics to a patient already 
nauseated, with the view of restoring the natural functions of 
the stomach. And the daily use of alteratives to bring about a 
gradual change in the fluids and solids is a very different thing 
from pure allopathy. It is very important to understand 
the terms of medicine, when we repeat them as we do household 
words. 

Aloes. — The inspissated or dried juice of the spiked aloe 
{Aloe spicata) is the same with what we usually call aloes. A 
good deal of uncertainty hangs over the natural history of this 
medicine, and therefore we shall not consume time in an attempt 
to investigate the matter. Some have alleged that all kinds of 
aloes come from one source, and that the diversity found in com- 
merce is owing to differences in the manner of collection. The 
island of Socotra, in South Africa, affords much of the article 
known as Socotrine aloes. The spiked aloe-tree grows there 
spontaneously, and yields the drug in large quantity. The full- 
grown and mature leaf of the tree is cut off by a clean incision, 
whereupon the juice flows freely. It is collected in proper vessels 
and gradually dried by moderate heat. When sufficiently inspis- 
sated it is poured into casks or skins. 

The usual commercial varieties are the Cape, Socotrine, and 



116 THERAPEUTIC PROPERTIES OF ALOES. 

Hepatic aloes. The cape variety is abundant and cheap, has a 
shining, vitreous appearance ; a strong and unpleasant odor 
when fresh, and more of a tinge of green than the other kinds. 
The Socotrine variety is the one generally employed in medical 
practice, and yet it is by no means certain that we always ex- 
hibit it when we intend to do so. It has a more agreeable odor 
than the other sorts, with more aroma, and a less unpleasant 
bitter taste. The best Socotrine aloes should have a reddish- 
brown color, break with easy fracture, and the powder should 
be of a bright golden color. What is called hepatic aloes is 
supposed to resemble the liver in point of color, or to be of a 
deep yellowish-brown. It has very little aroma, and is more 
unpleasant than the other varieties. Its powder is of a dull 
olive-yellow. It comes chiefly from the West Indies and Bom- 
bay. The foetid, caballine, or horse aloes, most probably got 
from the dregs of all the other kinds, is employed as a medicine 
for inferior animals. 

The general properties of all kinds of aloes are alike. They 
have in common an abidingly bitter taste, and all are cathartic. 
They contain bitter extractive, resin, and albumen, and, accord- 
ing to Braconnot, a peculiar principle. They yield their pro- 
perties to water, cold or hot, to alcohol, strong or diluted. 
Hence watery solutions, as well as tinctures, may be employed. 

The solution of aloes in the alimentary canal is accelerated 
by admixture with alkalies or soap. These alter the medicinal 
property a little, but lessen the irritant quality. 

We may very properly speak of aloes as possessing tonic, 
purgative, emmenagogue, and anthelmintic properties. The 
tonic power is not often resorted to, because we possess articles 
fully equal, and indeed superior, that are far more agreeable. 
Yet it is certainly capable of exerting a decidedly tonic influ- 
ence in doses of from a half to one grain, taken twice or thrice 
a day, in a pill or in any convenient way. Its bitterness is the 
basis of its tonicity ; while the mild action exerted on the bow- 
els, by removing offending matters from the intestines, actually 
increases the tonic effect. 

As a purgative or cathartic we give this medicine more fre- 
quently than for any other purpose. And as some diversity has 
obtained in regard to the mode by which this article effects pur- 
gation, it is needful to say a few words specially on that point. 
It was supposed, from the well-known fact that it acts chiefly on 
the lower end of the canal, that it failed to exert a cathartic 
influence higher up, because it required to travel almost the en- 
tire route of the bowels before enough could be dissolved to pro- 
duce purgation. That it does not stimulate the mucous mem- 
brane of the whole canal to pour out an increase of its natural 



MEDICAL USES. 117 

secretion is obvious from the fact that the stools are not watery 
but consistent. No matter how large the dose, (if under twenty 
grains,) it is not felt by the patient until it passes the sigmoid 
flexure of the colon. After that point has been reached an in- 
ternal commotion is realized and an evacuation soon follows. 

That the medicine does not require the long passage in the 
bowels merely to be sufficiently dissolved in order to purge is 
obvious from the well-known endermic use of it. Applied to 
an ulcer or a denuded spot it will as effectually and as promptly 
prove cathartic as when it is exhibited in the more usual way. 

All the varieties of aloes agree in the feature already named, 
viz., in acting on the lower portion of the bowels and inducing 
consistent discharges. This effect is not in the least degree 
altered by the form of administration. 

In considering the cathartic power of aloes it is proper to 
notice the popular error in regard to the agency of this medi- 
cine in producing hemorrhoidal disease or piles. This idea is 
favored by the peculiar tendency of aloes to act exclusively on 
the lower bowels ; and yet it is not true that the disease called piles 
depends so commonly as some believe on the use of this medicine. 

Much that is said of the evils growing out of the irritant 
action of aloes on the rectum is attributable to the abuse of the 
article. Too frequently employed, it will, as any other cathartic, 
irritate as well as purge. In the sedentary, who neglect to make 
use of the requisite exercise, and who consequently realize a 
constant determination of blood to the rectum and verge of the 
anus, we find nearly all the cases of piles that are the subjects 
of medical treatment. Such persons are almost constantly ha- 
rassed with constipated bowels, for the relief of which they re- 
sort to various cathartics, including aloes as a matter of course ; 
and if hemorrhoidal disease supervene or be made worse the 
entire result is attributed to the irritant action of aloes. We 
need not argue that the sedentary are, from the very fact of 
their constant sitting posture, liable to attacks of piles, for this 
is universally conceded. Such persons may suffer from piles, 
and yet may never have taken a dose of aloes, while some who 
have often swallowed that medicine in cathartic doses have real- 
ized no more than simple purgation from its use. 

The irritant action may sometimes do good. In persons of 
phlegmatic habits, whose entire system partakes of the torpidity 
that invades the bowels, who have defective appetite and mental 
langour, with all the symptoms that make up a case of hypo- 
chondriasis, large doses will often, even though they should 
prove a little drastic, do much good. A happy counter-irritation 
is established in the alimentary canal which, though transient, 
diverts morbid action from more important parts of the economy. 



118 ALOES AN EMMENAGOGUE. 

What is called the emmenagogue action of aloes is often due 
to the operation first named. Many dyspeptic females labor 
under derangement and inefficiency of the uterine system, asso- 
ciated with torpor of the bowels and defective appetite, who find 
relief from the daily use of small portions of aloes alone or in 
combination. I am well satisfied that such females are often 
injured by opiates taken to relieve present discomfort ; and these 
persons are as frequently and signally benefited by aloes. We 
may sometimes combine aloes with assafoetida and cantharides, 
with good effect, to excite proper uterine or ovarian action, to 
relieve suppression of the menses, even without regard to the 
presence of hemorrhoidal disease. The following prescription I 
have often found serviceable in delicate females, laboring under 
such disabilities, with loss of appetite and torpor of the alimen- 
tary canal: — 

R. — Pulv. aloes, opt. ; 

" asafoetid. aa gss; 
" cantharid. gr. xx. 

Rub these well together with a little soap and divide into 
twenty pills, of which give from one to three three times a day. 

To the articles of the above prescription we may add, if need 
be, some of the salts of iron ; especially will this be proper if 
the patient be very feeble. 

Aloetic injections thrown up the rectum repeatedly, a week 
before the menses should appear, and continued daily, have 
sometimes been very useful. From ten to thirty grains should 
be added to two or three ounces of water for this end. 

The anthelmintic power ascribed to aloes depends on the bit- 
terness of the article and its associated tonicity. In hundreds 
of cases the presence of worms in the alimentary canal is caused 
by long-continued atony ; and under such circumstances a feeble 
tonic, with the gently-cathartic power of small doses of aloes, 
will do good. The practice has been to dissolve two drachms 
of aloes and one ounce of liquorice-ball in a quart of hot water. 
A tablespoonful of the cold mixture may be given to a child 
from eight to ten years old, every morning. Children soon 
become accustomed to the dose. It speedily improves the appe- 
tite and expels the worms. 

But injections of aloes have proved beneficial in persons 
troubled with worms, especially the ascarides. From a scruple 
to a drachm of aloes dissolved in eight ounces of water makes 
the injection, of which a third or a half may be thrown up at 
once for children, or the whole quantity for an adult. 

An English physician, Dr. Greenhow, who has made a good 
many experiments with aloes, declares that the good effects of 
the medicine are greatly increased by long trituration ; and he 



DOSE OF ALOES — ALTERATIVE. 119 

also asserts that the griping tendency can be prevented by adding 
a few grains of the extract of henbane or hops, say from one to 
three. He says further, that two grains of ipecacuanha mixed 
with the aloetic dose will almost invariably prevent its irritant 
action on the rectum and verge of the anus, and that thus com- 
bined the subjects of piles may take it with entire safety. 

It is proper to name the circumstances which are held to forbid 
the use of aloes. The direction is to be regarded, however, as a 
general guide, to which there may be exceptions. The medicine 
is improper for persons of very plethoric habits, especially if 
they be a good deal irritable ; for persons actually laboring under 
piles ; for those who are liable to sudden uterine evacuations ; for 
females in the early months of pregnancy, who may have aborted. 
The sympathetic action of aloes from the rectum to the uterus 
might be very pernicious in such cases. 

The dose of aloes has been a subject of controversy. Some 
insist on small doses, often repeated, while others contend for 
large portions at a single dose. This diversity does not relate 
to the tonic power of the article, but exclusively to its cathartic 
efficacy. It must be remembered that all writers place aloes 
among the generally safe remedies. It is not regarded as highly 
energetic, nor dangerous. A dose of twenty or thirty grains 
might sometimes answer better than several of five grains re- 
peated. Much depends on habit here, and not a little on fancy 
and individual peculiarity. If the large dose be given it should 
be mixed with molasses, or syrup of any suitable kind, as few 
would relish six or eight pills for a dose. The latter is generally 
the most agreeable form of administration, and one or two pills 
can be tolerated by most patients. Those who fear the debili- 
tating effect of aloetic pills will do well to mix the aloes with 
enough of the soft extract of quassia to form a pill mass. 

We alluded before to the endermic use of aloes ; that is, the 
application of the medicine to the raw surface, as an ulcerated 
or blistered spot. Ten grains of fine powder of aloes laid on 
such a spot will purge in the course of six, eight, or ten hours, 
and thus the unpleasant taste of the article is wholly obviated. 

The compound Hiera picra, once a very popular medicine, 
consists of finely pulverized aloes and canella alba. Guiacum, 
aloes, and cinnamon, constituted a mixture once much in use, 
under the name of the compound aloetic powder. 

Alterative. — This is a therapeutic term applied to any sort 
of treatment that is calculated to induce a change in the blood, 
and consequently in all the secretions and tissues. There is 
probably no better illustration of an alterative medicine than we 
have in the administration of one-grain doses of blue pill daily, 
for several weeks, so as to avoid salivation altogether. The light 



120 ALUM. 

stools disappear and are succeeded by those of natural color, 
while the skin loses its yellow tinge and regains the usual appear- 
ance of health. 

Alumen. Alum. — Sulphate of alumine and potash, sulphate 
of alumine and soda, sulphate of alumine and ammonia. 

Common alum of commerce is found native in several parts of 
the world, in large masses. It may also be manufactured from 
what are called alum ores or earths. Roche, or roch, or rock 
alum abounds in Rocca, in Syria, and hence the name. These 
varieties are all composed of sulphuric acid, alumine, and potash. 
The sulphate of alumine and soda, called sometimes soda alum, 
was introduced to notice by Dr. Ure. It is very much more 
soluble in water than the common article ; and Ure regarded this 
as a matter of some importance, though his discovery has never 
been of much benefit to the profession. 

The sensible and obvious qualities of common alum are fami- 
liar to every one. Its decided acidity lays the foundation of its 
astringency, on account of which, chiefly, it is employed in 
practical medicine. Alum dissolves readily in water. A fluid- 
ounce of water at 60° will dissolve about thirty grains ; the same 
quantity of boiling water will take up two hundred and forty 
grains. Alcohol and sulphuric ether also dissolve alum, but the 
solutions are rarely resorted to. 

Before we notice the therapeutic uses of alum it will be well 
to say something touching its incompatibilities. The doctrine of 
incompatibility, so important in its various applications, has 
striking illustration in regard to alum. All the alkalies and 
alkaline salts are incompatible ; so are carbonate of ammonia, 
carbonate of magnesia, acetate of lead, the salts of mercury, 
many vegetable and animal substances. Now, when we speak of 
incompatibility here, we mean to say that a mixture of alum with 
any article named results in so much decomposition as to destroy 
the quality of one, and perhaps of all the articles blended to- 
gether. Thus, there are practitioners who mix alum and sugar 
of lead in the same prescription, a given quantity of water being 
employed for solution. Both alum and sugar of lead are astrin- 
gent ; and the mixture is made with the view of augmenting 
the astringent quality, and thereby better fitting it for a given 
case, as of hemorrhage or profluvium of some sort or other. But 
no sooner is the solution made, than the alum and sugar of lead 
cease to be, and two other salts are produced, viz., the acetate of 
alumine, which is exceedingly feeble, and the sulphate of lead, 
which falls to the bottom (because almost insoluble) and is ab- 
solutely inert. 

The prominent therapeutic property of alum is its astringent 
power. We have said enough on the general nature of astringent 






USES OF ALUM. 121 

action in our preliminary remarks, and need not repeat here. 
Everybody in and out of the profession understands sufficiently 
well what we mean by an astringent. This grand quality of 
alum laid the foundation for its general use in hemorrhages, 
fluxes, &c. Van Helmont exhibited it largely in uterine hemor- 
rhage, and, in fact, was the first to employ it in that form of 
disease. It is quite probable that this use of alum first suggested 
the employment of the sugar of lead for the same end. From 
five to twenty grain doses of alum have been given every three 
or four hours with happy result in this kind of hemorrhage, and 
the practice is still not unusual in some parts of our own country. 
So also it has been and is now given in diarrhoea, leucorrhoea, 
and the like, on account of its astringency. It is also reported 
as successful in dysentery, though we are inclined to believe that 
the cases were rather chronic diarrhoea. 

Laennec employed finely powdered alum in angina tonsillaris, 
variolous angina, and oedema of the glottis. He preferred the 
fine powder to all sorts of gargles, and introduced it by means 
of a goose-quill. He placed some of the powder in a quill, and 
passing this into the open mouth of the patient, blew the powder 
forcibly, so as to lodge it on the affected spot. The moisture of 
the parts gradually dissolved the alum and thus protracted the 
astringent action. 

In gonorrhoea the use of alum has had not a few advocates. 
The more common form has been by injection ; but we have here 
to notice its internal exhibition as peculiar to Germany. Dr. 
Frederick assures us that he has treated the inflammatory stage 
of gonorrhoea most successfully with the following mixture : — 

R. — Powder of alum, gj ; 
Water, ^vi; 

Extract of liquorice, gi. 
Mix well, and give a tablespoonful three times a day. 

The pain, ardor urinae, &c. soon abate, and the disease is ar- 
rested. Injections, made by adding from five to ten grains of 
alum to an ounce of decoction of oak bark, have been useful in 
gonorrhoea and gleet; and yet stronger injections are useful for 
relief of bloody discharges per anum. Solutions of alum and 
oak bark, or alum and water, have often been serviceable in sub- 
acute ophthalmia, and also as gargles for common sore throat. 
The latter practice is familiar to almost every head of a family, 
and is often beneficial, and generally safe. 

In typhoid fever, associated with exhausting looseness of the 
bowels, doses of from thirty to sixty grains of alum have been 
administered with decided advantage, as we learn from Villard's 
Hepertoire de Olinique, vol. iv. p. 88. Here, too, the medicine 
acts in virtue of its astringency. 



122 USES OF ALUM. 

Very many years ago alum -was employed in intermittent^ in 
doses of from five to ten grains, with as much of nutmeg, three 
or four times a day, during the intermission. We can hardly sup- 
pose that the good result in that case was due to astringency. 
The practice, however, has long since fallen into disuse. 

Most certainly the success of alum in the treatment of eolica 
pictonum, or lead colic, cannot depend on the astringent nature 
of the remedy. The practice is quite an old one, and has fre- 
quently been renewed, as may be seen by consulting the London 
Lancet for 1843, and Ranking' s Abstract for 1849. Professor 
Benj. Smith Barton, formerly of the University of Penn- 
sylvania, was in the habit of saying to his class, that, however 
strange it might seem, "some astringents do actually purge." 
He named alum, especially, as in point, in doses of from thirty 
to sixty grains. 

Mr. Copland says, in his Dictionary of Practical Medicine, 
"that Schmidtman details a case in which the exhibition of two 
or three doses of alum produced a most copious operation on 
the bowels after the most active purgatives had been given by 
the mouth and per anum without any effect. When residing on 
the continent, in 1818 and 1819, I saw many cases treated by 
this substance, given in doses of from a scruple to two drachms 
in gum-water, or with camphor and opium. M. Kapeler, in his 
hospital, into which many cases of the disease are admitted, 
employed scarcely any other medicine than alum dissolved in 
mucilaginous decoctions, assisting its action by oleaginous clys- 
ters. The worst cases, those with paralysis, loss of sight and 
hearing, violent cephalalgia, tremors of the muscles and limbs, 
&c, were restored in a much shorter time by this than by any 
other treatment, and with much less disposition to relapse or to 
pass into a paralytic state. I have employed alum with uniform 
success in several cases, and combined it with camphor, Cayenne 
pepper, and occasionally with opium; and have always found 
that when given in sufficient quantity, from two to four or five 
drachms in the twenty-four hours, and assisted by oleaginous 
clysters, it will open the bowels more certainly than any other 
medicine. M. Gendrin has recently given alum in fifty-eight 
cases of this disease, all of which recovered in from three to 
five days. He has also found that a drachm or a drachm and 
a half of sulphuric acid in the twenty-four hours, taken in three 
or four pints of water, is equally prompt and efficacious." 

M. Brachet, of Paris, confirms the testimony of Gendrin very 
decidedly. He prescribed from one and a half to two drachms 
in a ptisan, to be taken during the day, adding forty or fifty 
drops of laudanum ; and if the bowels were not moved by the 
third day he gave a mild aperient. One hundred and fifty cases 



USES OP ALUM. 123 

were so treated with entire success. — Brit, and For. Med.- 
Chirurg. Rev., January, 1851. 

Dr. Tocld and others have endeavored to account for the 
happy action of alum in lead colic by supposing that chemical 
decomposition ensued, in virtue of which the carbonate of lead 
in the system was changed into a sulphate. Be this as it may, 
it is certain that lead colic has often yielded to large doses of 
alum, and that these have purged the patient when ordinary 
cathartics were inert. The truth is that the intestines are para- 
lyzed by the action of the lead poison, and it may be that there 
is a special adaptation of the alum to that condition, which being 
subdued, purgation readily follows. 

But if alum cannot accomplish its good effects in colica picto- 
rum in virtue of its astringency, can it do what it is said to induce 
in croup by that sort of agency ? Prof. Meigs, of Jefferson Me- 
dical College, Philadelphia, is quite partial to large doses of 
powdered alum for young children affected with croup of the in- 
flammatory kind. He says he has given the medicine as an 
active emetic for more than twenty years. Its rapidity and 
certainty of action are assigned as the prominent qualities. A 
teaspoonful in syrup of any kind is given every ten, fifteen, or 
twenty minutes. Seldom is it needful to give more than one or 
two doses. Dr. M. names, as an additional feature of high 
value in this medicine, its failure to depress or exhaust the 
system as do other emetics, and especially tartar emetic. 

We do not find in the profession at large a disposition to 
adopt this kind of emetic practice, notwithstanding the high en- 
comiums passed on it by Professor Meigs. In fact, we have 
heard but one other gentleman speak of its exhibition, and his 
experience was not very favorable. We trust, however, that a 
remedy so highly endorsed will not be neglected simply because 
it seems to be a little paradoxical to employ an astringent in 
this way. 

Dr. Andrews speaks of the use of alum in pertussis, bron- 
chitis, and croup, in a paper dated Feb. 1844, and published in 
the London Lancet for that year. He did not employ it as an 
emetic, but as a sedative. 

There are two preparations made of common alum which arc 
often valuable, viz., the alum curd, and alum ivhey. The curd 
is readily formed by agitating a lump of alum (say a drachm or 
two) in the whites of two or more eggs ; the albumen is soon co- 
agulated or curdled, and is placed between pieces of fine gauze, and 
then applied over the eye laboring under subacute ophthalmia. 
It affords much relief, and is extremely grateful to the patient. 

The ivhey is prepared by boiling 5\j of alum in a pint of new 
milk for the space of five minutes or less. Strain through 



124 AMMONIA. 

gauze, sweeten, and add nutmeg, if agreeable. The dose is a 
wineglassful from three to six times a day. It is a cooling, 
astringent drink, suited to cases of internal hemorrhage, gleets, 
and the like. 

Alum has the property of retarding fermentation, and is added 
to the paste of paper hangers for this end. It speedily removes the 
turbidness of river-water, and is much used on the Ohio river for 
this purpose. A drachm or two will suffice for five gallons of water. 

A few words are necessary on the article called burnt alum. 
It is the Alumen ustum, or exsiccatum of the old books, and is 
made by exposing common alum to heat, as on a shovel laid on 
burning coals. The salt is fused, the water of crystallization is 
expelled, and a dry, porous, light, white mass remains. The 
burnt alum so formed is employed externally as an astringent 
and escharotic. Mixed with equal parts of fine white sugar and 
applied to what the common people call proud flesh (profuse 
granulations) its gentle caustic power is developed. Jobert, in 
the French Lancet for 1835, speaks well of the burnt alum for 
stricture of the urethra. He makes the fine powder into a paste 
with sweet oil, and coats his bougie with the paste ; thus prepared 
the bougie is passed into the urethra. 

But the article has also been employed internally in lead colic, 
in twenty and thirty grain doses, repeated every three or four 
hours. It was first used thus by Grashius, and Paris bears 
decided testimony in its favor. 

Large portions of common alum and also of burnt alum have 
poisoned. One or two ounces will give this result. The reme- 
dies are large draughts of warm water and a solution of soap, so 
as to vomit freely. The patient is soon relieved. 

Ammonia. — This is the volatile alkaline base of several im- 
portant compounds. The word ammonia is taken from Jupiter 
Ammon, near whose temple sal ammoniac was first found. 
The native state of pure ammonia is that of gas, but as such 
it is rarely employed in practice, though the gas be really the 
efficient agent of several ammoniacal compounds. The gas, 
which is readily made by heating a mixture of quicklime and sal 
ammoniac, is rapidly absorbed by water, and in this way is pro- 
duced the article called aqua ammonia?, or water of ammonia, 
and liquid ammonia.- An article very similar is formed by the 
distillation of hartshorn or other bones, and hence the term 
hartshorn, as frequently employed. What is called the spirit or 
alcohol of ammonia is the same gas absorbed by alcohol. 

The forms of liquid ammonia above named are very frequently 
employed by the physician both externally and internally. Their 
primary action is stimulant in all cases. And when we call an 
article like this a rubefacient we mean to say that it first stimu- 



USES OF LIQUID AMMONIA. 125 

lates or excites the skin, more blood is determined to the spot, 
and a kind of inflammatory action is set up. Hence the import 
of the word rubefacient is to redden. We invite by the use of 
such articles an unusual quantity of blood to the spot. 

The rubefacient use of liquid ammonia is quite extensive and 
very valuable. The promptitude of its action depends on its 
strength ; and as the article is on sale of several grades of con- 
centration, this fact should be borne in mind, whether we need it 
for internal or external use. A good deal, too, depends on indi- 
vidual cutaneous sensibility. In some persons, a cloth wet with a 
weak article will instantly excite redness and stinging ; in others, 
a much stronger preparation will be slow to develop the same 
result. We see this often in the application of liquid ammonia 
to the throat to relieve what is usually called sore throat. The 
design is to transfer inflammation from the mucous tissues within 
to the surface, and to fix it there, and this is frequently accom- 
plished. A very good plan is to make a flannel bandage as hot 
as possible and to moisten it with the liquid ammonia, and then 
to wrap the flannel close round the throat. In a few minutes, 
ordinarily, the rubefacient action will be obvious and relief will be 
obtained. Pringle was very partial to this use of liquid ammonia 
in the early stage of cynanche tonsillaris, and the practice is yet 
in use. The mixture called volatile liniment is often substituted 
for the liquid ammonia because less apt to be severe in its opera- 
tion. If the strong liquid ammonia be employed alone it may 
actually vesicate, which, though probably all the better for the 
patient, is undesirable. The union of oil with the liquid ammo- 
nia blunts the energy of the latter, while the mixture retains a 
rubefacient power. Hence the importance of the compound. To 
make it, we prefer to pour the strongest liquid ammonia into a 
phial, and then to add sweet oil until a soap is formed, shaking 
the phial repeatedly to make the union complete. The books 
give directions as to quantity, but these fail sometimes, owing to 
defect of the liquid ammonia. To give the volatile liniment an 
anodyne quality we add to each ounce about a grain of the sul- 
phate of morphia, or thirty drops of laudanum. This mixture is 
an excellent application for the relief of chilblains, and should 
be rubbed into the parts at night, after a previous ablution with 
warm soapsuds. 

But besides the mere rubefacient use of liquid ammonia it is 
resorted to as a very speedy vesicant. The latter is but an aug- 
mentation of the former, and hence it occurs, in persons of very 
tender skin, that we sometimes blister when we designed only to 
redden the skin. 

The vesicant use of liquid ammonia is important as a quick 
mode of setting up endermic medication, and is too little known 



126 USES OF LIQUID AMMONIA. 

to the profession at large. We separate the cuticle in a few 
seconds or minutes by this contrivance, instead of waiting the 
slow action of cantharides. To vesicate with liquid ammonia we 
must employ the most concentrated article. An excellent plan 
for speedy vesication, to prepare for the application of energetic 
medicines to the skin, is to lay a heated dollar on a plate, and over 
it two circles of old linen rather less than the dollar in size. Satu- 
rate these with the strong liquid ammonia and apply the whole 
to the skin, the dollar remaining on the linen. Press on the 
dollar for the space of from five to ten minutes, and there will 
usually be complete vesication. The cuticle being next removed 
we can at once apply salts of morphia or other medicine to the 
spot with happy effect and with very little loss of time. 

The celebrated lotion of Granville is composed of the most 
concentrated liquid ammonia, distilled spirit of rosemary, and 
spirit of camphor. It induces vesication almost immediately. 
For the particular formula consult the American Journal of 
Pharmacy, vol. v. p. 174. 

The following is a good substitute : — 

Take of strongest liquid ammonia, five ounces ; 

Tincture of camphor, two ounces ; 

Spirit of rosemary, one ounce. 
Mix. 

The blistering ointment of Gondret is made of the strongest 
liquid ammonia, oil of almonds, and lard. It will vesicate in ten 
minutes. Of the same nature is the pommade of Trousseau, and 
several other preparations largely employed in France. The 
prominent ingredient of many similar articles is confessedly 
some form of liquid ammonia. 

Injections of this stimulant medicine have been found very 
useful in some forms of uterine disease. In the proportion of a 
drachm to a pint of water it has thus been employed in cases of 
cancer uteri. It is said to remove or greatly to lessen the 
uterine pains, the foul odor of the discharges, &c. Similar 
injections have been tried beneficially in the various forms of 
deranged menstruation, but the practice demands judgment and 
discretion. The local stimulation of ammonia that would be 
useful in one case might do harm in another. 

But there has been and yet is much use of liquid ammonia as 
an internal medicine ; and here the range is very great. As a 
mere antacid it is often serviceable ; and if the patient be very 
feeble it will prove a happy diffusible stimulant. In such cases 
it is preferable to sulphuric ether, so often resorted to by pa- 
tients because of its more grateful properties. The ether wholly 
fails to relieve the acid condition of the stomach, though its 
stimulant character is undoubted. The liquid ammonia answers 



USES OF LIQUID AMMONIA. 127 

both intentions very happily. The adult dose may be from five 
to thirty drops in a tablespoonful of water, three or four times 
a day. Like all alkaline medicines it should not be resorted to 
daily as a mere habit, not only because it loses its power for the 
given end, but it may actually exert a bad influence on the mu- 
cous tissue of the stomach. 

When we desire to make a sudden and somewhat severe im- 
pression on the system we give a teaspoon half full or quite 
full at a dose. Thus it has been administered just as a chill of 
ague and fever was expected, with the effect of preventing the 
dreaded seizure. Here it acts by the shock suddenly imparted, 
and which so affects the nervous system as to break up for the 
time the morbific associations which constitute the periodicity of 
the disease. 

The stimulant power of liquid ammonia is also useful in old 
and obstinate cutaneous eruptions, and especially when these 
suddenly disappear. It not only operates as a stimulant to the 
whole system, but to the capillaries in particular, and thus the 
retrocedent disease is made to return. The adult dose here 
should not be over twenty drops at one time, repeated if need be 
every two hours in a small quantity of warm water or ginger tea. 

On the same principle of exciting the action of the cutaneous 
vessels this medicine is also useful in chronic rheumatism, though 
part of its good effect is due to its power to neutralize acid, 
which is almost always abundant in the stomachs of rheumatic 
patients. Breschet, who was partial to this use of liquid ammo- 
nia, generally combined some preparation of opium with it, and 
very properly, because of the need of allaying pain. 

A very important application of this medicine is in the treat- 
ment of neuralgia of the face and head, accompanied by severe 
headache. The best mode of exhibition is to give the patient 
from twenty to forty drops of the concentrated article in a cup 
of gruel at bedtime, or whenever the pain may be most severe. 
The medicine should be well mixed with the gruel and the whole 
taken at once. At the same time it will assist the operation if 
a portion of the ammonia be rubbed into the painful spot. The 
cases cited by the foreign journals in this relation are very in- 
teresting, and we have no hesitation to commend the practice to 
persons who suffer from this distressing malady. 

In asthma, which so often baifles medical skill, the application 
of strong liquid ammonia to the velum palati, on soft lint, though 
for a moment, will often put a stop to the paroxysm. The pa- 
tient is often found to be half suffocated by the disease, and 
although the sudden contact of lint soaked in ammonia with the 
back part of the mouth may temporarily augment the suffoca- 
tion, its action is of such a nature as to break up the asthmatic 



128 POISONOUS ACTION OF LIQUID AMMONIA. 

paroxysm and to give great ease to the sufferer. Coughing is 
instantly excited, the spasmodic stricture is gone, expectoration 
ensues, and respiration becomes more natural. The operation 
may be repeated if circumstances demand, and is perfectly safe. 
The practice has the high sanction of Rayer, and is stated fully in 
the Bulletin des Sciences Medicales, to which the reader is referred. 

In the London Lancet for October, 1846, will be found strong 
testimony in favor of the use of liquid ammonia in pertussis ; 
and I suppose its efficacy there is based on the same principles 
that make it valuable in asthma. There should, of course, be 
more caution in its exhibition to children. In both diseases the 
same medicine has been given internally, as we are assured, with 
manifest benefit. 

Dr. S charm, a German physician, speaks in high terms of 
commendation of the use of liquid ammonia in delirium tremens. 
He declares that he has been able to tranquilize the system and 
give sound sleep by the exhibition of teaspoonful doses of this 
medicine. We regard it as decidedly more safe than the exces- 
sive opiate dosing, so popular in many parts of the world. 
Certainly the remedy is worthy of notice in this country, where 
the disease so terribly abounds. 

The poisonous action of liquid ammonia merits a few remarks. 
It acts as an irritant poison, as might be expected from its 
well-known properties. I knew a young child just able to walk 
poisoned by swallowing the contents of an ounce phial of this 
medicine. Instantly there was terrible suffocation, and fortu- 
nately vomiting expelled a large portion of the poison. A mix- 
ture of vinegar and water was freely given to the child and it 
recovered. In lieu of vinegar any vegetable acid might be 
employed, as, for instance, lemon juice diluted, or a solution of 
tartaric acid ; and if none of these could be had, oil should be 
poured down freely, so as to neutralize the alkali and form a 
soap. A very interesting case is given in detail, showing the 
symptoms and treatment very satisfactorily, in the London 
Lancet for 1846. 

The Edinburgh Medical and Surgical Journal, July, 1841, 
furnishes the following very interesting case of poisoning by the 
inhalation of the gas of liquid ammonia : — 

A young man who slept usually in a chemical laboratory was 
poisoned by the fracture of a vessel containing nearly fifty pints 
of volatile alkali, (liquid ammonia.) The accident occurred in 
the night, without his knowledge, and he was exposed to the 
vapors nearly an hour. He was roused by violent constriction 
of the throat and dyspnoea. He arose, but felt suffocated, and 
would have perished if a woman who heard his feeble cries had not 
come to his rescue and at the risk of her own life dragged him out. 



AROMATIC SPIRIT OF AMMONIA. 129 

"When seen by the physician the patient's countenance was 
extremely anxious. His face was covered with livid streaks, 
especially about the nostrils. The mucous membrane of the 
mouth and nostrils appeared to be destroyed, and bloody frothy 
matter flowed from the mouth and nose. The tongue was of a 
bright-red color, and had lost most of its cuticular covering. 
The voice was very feeble, and the man complained of a sharp 
pain in the throat, which soon extended to the breast. The dysp- 
noea was extreme and fits of suffocation frequent. He had 
great thirst, and deglutition was almost impossible. The pulse 
was feeble, irregular, and quick. 

Bleeding was resorted to liberally, and water acidulated with 
vinegar injected in large quantities, (probably by the mouth and 
rectum, though it is not stated.) At the end of two hours the 
symptoms abated in severity, excepting the difficulty of swal- 
lowing, which increased. By frequent friction and leeches to 
the throat, gargles, injections, and baths, he was declared to be 
out of danger at the end of forty-eight hours. Loss of voice 
continued for six days, but after this he recovered rapidly. 

The aromatic spirit of ammonia, or the volatile aromatic spirit, 
is a compound to which many practitioners are very partial. It 
is a good diffusible and soothing stimulant. Any one can make 
it extemporaneously to suit his fancy and the special case, but a 
more common formula is thus : — 

R. — Spirit of ammonia, two pints; 

Essential oil of lemons, two drachms ; 
Nutmegs, bruised, a half-ounce ; 
Cinnamon, do., three drachms. 

Macerate in a close vessel for three days, shake occasionally, 
and distil a pint and a half. A good substitute might be had at 
once by the following combination : — 

R. — Spirit of ammonia, ^i; 

Oil of lemon, 

Oil of rosemary, aa five drops. 
Mix. 

The usual adult dose of the aromatic spirit of ammonia is 
from twenty to sixty drops, properly diluted with water. It is 
a very pleasant article, especially to delicate females laboring 
under acidity of stomach and sick headache. I have given it 
to such persons to prevent the unpleasant effects that sometimes 
follow or attend the exhibition of sulphate of quinine and known 
under the name of quininism. My plan has been to direct from 
ten to twenty drops to be taken every hour or two during the 
use of the antiperiodic. 

The spirit of ammonia has, by very many at home and abroad, 
been regarded as a valuable addition to astringent and anodyne 



130 HYDROCHLORATE OF AMMONIA. 

medicines in the treatment of Asiatic cholera, and we shall have 
occasion to allude to it again in this relation. 

The fetid spirit of ammonia has also some claims to our 
notice. It is a medicine, however, that demands no set formula, 
because its component parts should be joined to suit each par- 
ticular case. It is sometimes made by digesting the fetid gum 
in liquid ammonia ; but I prefer to make it as I need it, by add- 
ing the fetid tincture to the aqua or spiritus ammonias. A 
teaspoon half full of the former and twenty drops of the latter 
will make a suitable dose for an adult, and is often useful as a 
diffusible stimulant in hysterical cases. 

The first salt of ammonia to be noticed is the old sal ammo- 
niac, the hydrochlorate or muriate of ammonia. Though found 
native in Africa and elsewhere, it can be prepared by the union 
of hydrochloric acid gas and ammoniacal gas, or by the double 
decomposition of sulphate of ammonia and muriate of soda. 
The salt is exceedingly hard and therefore difficult of pulveriza- 
tion ; has an acrid, bitter, yet rather cooling taste, and when 
pure is nearly white. It is not easily affected by heat. Three 
parts of water at 60° dissolve one part of the powder, while 
boiling water takes up its own weight. 

The incompatibles of this salt are the mineral acids, potash 
and its carbonates, soda, lime, magnesia, most metallic salts 
whose base forms insoluble salts with muriatic acid. 

The refrigerant property of sal ammoniac is sometimes em- 
ployed in medical practice. Solution in cold water obviously 
reduces the temperature, and in this state the mixture is occa- 
sionally applied to indolent tumors and to abate heat of the sur- 
face. It must of course be used as soon as the salt is dissolved, 
or it will be no more refrigerant than ordinary cold water. 

The watery solution mixed with an equal quantity of vinegar 
of squills has been successfully applied to the hydrocele of in- 
fants. A cloth is soaked in the mixture and kept constantly on 
the parts. It acts, in part, by stimulating the absorbents to 
unusual energy, for the removal of the effused fluid. Another 
use of the watery solution is for the relief of severe headache ; 
but here it acts most probably by carrying off excess of heat, 
which is so common in some varieties of that affection. Some- 
times a very concentrated watery solution is usefully employed 
as a gargle to relieve an inflamed throat, a prominent symptom of 
the case being a persistent burning in the fauces. Here the 
gargle should be used very frequently, and must be fresh made 
in order to have the refrigerant effect. It also operates under 
these circumstances partly as an astringent and by setting up a 
new action. 

Weak watery solutions of sal ammoniac have long been em- 



USES OF SAL AMMONIAC. 131 

ployed by the French as lotions for subacute inflammations of 
the eye. From one to three grains are dissolved in an ounce of 
rose water and applied frequently on soft lint. 

Sal ammoniac has long been popular as an external remedy 
for itch and some other cutaneous affections. I have found it 
useful in a variety of skin diseases attended by troublesome 
itching. A drachm of the finely pulverized salt should be well 
rubbed with an ounce of common sulphur ointment, and a portion 
of the mixture rubbed on the parts affected night and morning. 

Paris speaks well of a stimulant plaster into which the salt 
enters and is undoubtedly decomposed. It is made by incorpo- 
rating an ounce of brown soap with two drachms of lead plaster, 
and then adding a half-drachm of powdered sal ammoniac. 
The mixture is to be spread on leather as soon as made and 
applied to the skin, and renewed at least once in twenty-four 
hours. The alkali of the soap combines with the hydrochloric 
acid of the sal ammoniac, thus setting free its ammoniacal gas, 
which acts on the skin as a stimulant and rubefacient. The 
plaster has been useful in affections of the chest, especially when 
applied to recently-blistered spots, and it is sometimes resorted 
to for relief of rheumatic pains. 

The internal exhibition of this salt has been confined very 
much to the Germans, who resort to it frequently in the belief 
that it exerts a happy influence on the secretions when all other 
medicines fail. Hence they employ it in the management of 
obstinate intermittens, generally in combination with Peruvian 
bark. The dose is from one to three grains, repeated three 
times a day or oftener. In phthisis pulmonalis also they have 
been very partial to its use, and have professed to derive much 
benefit from it. In one case a drachm was given every two 
hours until, in the course of three months, a pound had been con- 
sumed. The night sweats, sickness of stomach, and general 
debility were obviously abated, and the patient greatly improved. 
Sometimes they combine it with sulphur, under an impression 
that the lung disease has an important association with a morbid 
state of the skin. Thus: — 

U. — Sal ammoniac, ^i; 

Flowers of sulphur, gij. 
Mix, to make twenty-four powders, one of which to be given every two 
hours. 

The dose of sal ammoniac here is just twenty grains. In all 
the cases of alleged cure or relief of pulmonary disease by this 
medicine the breast was kept under the constant irritant influ- 
ence of a tartar emetic plaster, which did much more for the 
patient than the internal medicine. 

Dr. Watson strongly recommends sal ammoniac in what he 



132 USES OF SAL AMMONIAC. 

denominates faceache, which is often a very troublesome and 
tedious affection. He regards the disease as essentially rheu- 
matic, which is probably the fact. Half-drachm doses of the 
salt, dissolved in as little water as possible, were taken three 
times a day, with manifest benefit, though I should be very apt 
in such cases to try the external use of strong liquid ammonia 
at the same time. 

The next internal use to be named is an American practice 
first introduced by Dr. Somerville, of Virginia, and recorded in 
the American Journal of Medical Sciences, vol. xix. A similar 
practice has since been announced by Professor Grillo, an Ita- 
lian. The disease in which these gentlemen employed the me- 
dicine was ischuria. The first case in which Dr. S. employed 
the sal ammoniac in this affection was an old man of seventy, 
who was attacked with the disease while laboring under bilious 
fever. It became necessary to resort to the catheter daily for 
the space of three months ; and finding little relief from that 
expedient, excepting of a merely transient nature, he gave the 
following mixture : — 

R. — Pulv. g. Arab. !|ss; 
Aquae, Ifxxiv; 
Pulv camphor, gr. iij ; 

sal amnion, gr. v. 

Mix, and give one-fourth at a dose, and the residue in three parts, at in- 
tervals of one hour. 

Sometime before the whole was consumed the urine began to 
pass freely ; at first with pain, but at last without discomfort. 
The prescription was continued for three weeks, and the patient 
entirely recovered. 

The last internal use of this salt which I propose to mention 
is taken from De Eoy's Materia Medica, and is highly praised. 
The preparation is called ammonical beer, and was employed in 
cases of scrofula, typhoid fever, and diabetes, with a view to 
rectifying the state of the blood. We do not know that the 
prescription has ever been tried in this country. It is thus : — 

Take of powdered sal ammoniac, two drachms and a half ; 

Table-beer, sixteen ounces. 
Mix. The dose is a wineglassful for an adult, three times a day. 

Very large quantities of sal ammoniac are decidedly poison- 
ous. It is an irritant poison, inducing vomiting and sometimes 
delirium, inflammation of the stomach, &c. The stomach should 
be emptied immediately and diluents of a mucilaginous quality 
given, and, if need be, leeches applied to the epigastrium. 

The carbonate and bi-carbonate of ammonia are next to be 
noticed. The carbonate is frequently spoken of as the volatile 
salt, volatile alkali, smelling salt, prepared ammonia, &c. It is 



CABBONATE OF AMMONIA. 133 

made from the double decomposition of chalk or carbonate of 
lime and sal ammoniac, or hydrochlorate of ammonia. These 
ingredients, reduced to powder and well mixed, are placed in a 
retort and exposed to sufficient heat to sublime. 

Carbonate of ammonia is a much whiter salt than sal ammo- 
niac, and much more readily pulverized. It is a hard, trans- 
lucent, striated mass, emitting a very pungent odor and having 
a sharp urinous taste. Its solution acts on vegetable colors just 
as those of any of the alkalies. It differs from sal ammoniac in 
its easy spontaneous decomposition and depreciation if left un- 
stopped. Glass bottles with well-ground stoppers are necessary, 
in order to long preservation. Besides the loss of its pungency, 
when not thus kept, it becomes opake and effloresces, and at last 
falls into powder which is almost destitute of sensible qualities. 

Carbonate of ammonia dissolves in water, and more abun- 
dantly if the water be heated. If the temperature be over 150° 
the salt is liable to be decomposed, and therefore is not to be 
administered in very hot liquids. It is wholly insoluble in alcohol. 

The incompatibilities of carbonate of ammonia are all the 
acids, the fixed alkalies, carbonate of lime, magnesia, alum, 
cremor tartar, acidulous salts generally, Epsom salt, corrosive 
sublimate, calomel, sugar of lead, salts of iron and zinc, and 
hot infusions or decoctions as before named. 

It is proper also to say that carbonate of ammonia is liable to 
be decomposed if reduced to powder and so put up in small 
papers for use. It is much better to give it in pill with some 
vegetable bitter extract, or conserve of roses, or mucilage of 
gum Arabic. 

The volatile julep is an excellent preparation of carbonate of 
ammonia. The following prescription is a good one : — 

Take of carb. ammonia, gi ; 
Powder of gum Arabic, 
White sugar, aa gij ; 
Cinnamon water, ^v. 

Mix, secundem artem, and give an adult a tablespoonful every two or three 
hours. 

Each dose will contain about six grains. This mixture is a 
good diffusible stimulant and expectorant. It is often a very 
useful medicine for the relief of that gastric atony consequent 
on habits of intemperance, and which is realized by those who 
lay aside strong drink suddenly. Taken every hour or two it 
will often avert an attack of delirium tremens in such individuals. 
I have often used the julep in pneumonia, after bleeding which 
did not sufficiently relieve the difficulty of expectoration. It 
will also be found an excellent medicine in cases of obstinate 
hoarseness which sometimes amount to complete aphonia. In 



134 USES OF VOLATILE ALKALI. 

these cases it is well to gargle with a portion of the julep, at the 
same time employing volatile liniment or pure liquid ammonia to 
the throat externally. 

In low fevers the volatile julep is often very beneficial, exert- 
ing an almost immediate influence on the whole economy. Its 
force is spent chiefly on the nervous system, and not very ob- 
viously on the heart and arteries. Occasionally it gives a very 
salutary diaphoresis. 

The addition of opium, laudanum, or a salt of morphia, makes 
the julep a very good medicine for many cases of protracted 
diarrhoea, where the vital energies are much enfeebled. Thus :— 

R. — Carb. ammon. gi; 
Pulv. g. Arab., 
Sacch. alb. aa gij ; 
Acet. morph. gi\ ij ; 
Aq. menth. ^vi. 
Mix, and give a tablespoonful every two hours. 

I knew a professor of Materia Medica who sent a prescription 
for the volatile julep to a distinguished medicine shop in an 
eastern city, and in place of two drachms of carbonate of am- 
monia he directed two ounces for a six-ounce mixture. The 
apothecary, well acquainted with the doctor, resolved to have a 
little fun with him for the blunder. The prescription was pre- 
pared as it should be. At the dinner-hour of the doctor the 
apothecary called to see him in great apparent perturbation, pro- 
fessing fears that he had committed a grievous mistake, which 
might be fatal to the patient. The prescription was exhibited, 
and the affrighted professor started in haste to visit the patient 
and arrest the administration of the medicine, when the apothe- 
cary, finding the joke had been carried far enough, told the whole 
story, to the great relief of the prescriber. Fortunately, how- 
ever, it would not be practicable to make a six-ounce vial hold 
the contents of the prescription just referred to, so that a mo- 
ment's reflection would have quieted all apprehension. 

The external uses of carbonate of ammonia are various. Re- 
duced to a coarse powder and mixed with some aromatic oils it 
constitutes a good smelling salt for the temporary relief of a 
tendency to faint, so common in delicate females. Applied to 
the nostrils its stimulation is speedy and salutary. The coarse 
powder applied to the skin is decidedly rubefacient, if confined 
to the spot by means of compress and bandage. It may also be 
rubbed with oil or lard, or simple cerate. The addition of pow- 
dered opium to the ointment so made will give a good application 
to parts laboring under rheumatic pains. A plaster made by 
mixing one part of carbonate of ammonia with three parts of 



POISONOUS ACTION OF CARBONATE OF AMMONIA. 135 

extract of belladonna, and spread on leather, is also frequently 
employed with benefit for the relief of local pain. 

Carbonate of ammonia is sometimes a good emetic, and is 
specially suited to cases in which a depressing or sedative emetic 
is forbidden. From a half to a whole drachm dissolved in a 
teacupful of warm water will induce vomiting in the space 01 
from fifteen to thirty minutes. It is a good substitute for the 
mustard emetic. 

Carb. ammonia is sometimes the occasion of poisoning. Too 
long-continued application to the nostrils has induced severe and 
fatal bronchitis. In the Ed. Med. and Surg. Journal, vol. xiv., 
is an interesting case of this kind, in which death resulted in 
forty-eight hours. Such cases indicate the importance of caution 
in the local use of the remedy. Too large doses taken into the 
stomach set up inflammation of the mucous membrane. Hux- 
ham records the case of a young man who acquired the habit of 
chewing the carbonate in lieu of tobacco, until it induced hemor- 
rhage from the gums, nose, and bowels. His teeth fell out, 
hectic fever ensued with extreme exhaustion, and death at length 
closed the scene. For an over dose, vinegar and water, or di- 
luted lemon juice, will be found the best antidote. 

Acetate of ammonia is the salt which constitutes the ancient 
Spiritus mindereri, an excellent medicine, much employed, espe- 
cially in the treatment of fevers. 

Various modes are pointed out for the preparation of this 
mixture. Carbonate of ammonia is the basis with which we may 
unite any form of acetic acid. The pure acid, distilled vinegar, 
or good common vinegar will answer. The purer the acid, the 
more desirable is the preparation on the score of appearance. 
To make it we may add to the powdered carbonate as much 
acid as will entirely decompose it and exactly neutralize the 
ammonia ; and this is precisely what is meant by saturation. 
Brande says, " four pints of distilled vinegar are requisite for 
the saturation of seven drachms of the carbonate;" but some- 
thing, as to the exact result, depends on the real strength of the 
distilled acid. We cannot rely on weight and measure, but must 
add the ingredients until there is exact neutralization. An ex- 
perienced operator determines this by his taste, but a novice 
should employ the test power of litmus paper, which will not be 
changed to red nor green if neither acid nor alkali be in excess. 

In the method above stated all the carbonic acid of the car- 
bonate is lost. To prevent this, and to have the benefit of the 
acid gas in the mixture, the following plan is to be adopted. 
Having ascertained the relative strength of your acid and car- 
bonate, place both in a strong bottle, having previously reduced 
the carbonate to powder. Instantly close the bottle with a good 



136 USES OF SPIKITUS MINDERERI. 

cork and tie it down. The decomposition of the salt will go 
on and be completed in a few minutes, and whenever a dose is 
poured out the sparkling qualities of a carbonated water will be 
obvious. The cork should be replaced as soon as possible after 
a dose is poured out, and the bottle should be inverted, with the 
neck in water. Those who have employed the spirit of minde- 
rerus thus prepared assure us that it agrees much better with 
delicate stomachs than the medicine as ordinarily prepared. 

The inventor of this medicine first employed it in fevers with 
a view chiefly to its diaphoretic effect. But it is important to 
bear in mind that this effect will not follow in the early stage 
of fever of high excitement. The system must be reduced by 
bleeding or other depletion before a diaphoresis will be secured 
by its exhibition. As there is often a torpid state of the bowels 
in febrile affections, I have been in the habit of adding to the 
mixture a small portion of the sulphate of magnesia. The use 
of a warm bath to the feet and legs is often a safe and salutary 
adjuvant. 

In some cases instead of torpor of the bowels there is an op- 
posite condition, and then, in place of Epsom salt, we add one 
or two grains of the acetate of morphia to six ounces of the 
spiritus mindereri. The dose of this medicine will necessarily 
vary according as it is made of pure acetic acid or of common 
vinegar. A teaspoonful of the former will be nearly equal to a 
tablespoonful of the latter. It should be followed by draughts 
of warm tea, as balm or sage tea, which will assist in securing 
the diaphoretic effect. 

From a great deal of experience in the use of this remedy in 
bilious remittents I became very partial to it. During a period 
extending from 1823 to 1827 intermittents and remittents were 
epidemic in many parts of Pennsylvania and the neighboring 
States, and my opportunities for testing the value of this article 
were exceedingly numerous. The details of practice were of 
course varied necessarily to suit peculiarities. It was not often 
that bleeding was required. If the condition of the head, or of 
any other part, demanded it, the remedy was employed. More 
frequently the treatment of the remittents was commenced with 
my favorite emeto-cathartic, consisting of calomel and jalap, 
each five grains, mixed, and repeated every half-hour or hour 
until three or four doses were taken. Copious discharges by 
the mouth and rectum generally followed; and if the bowels 
were not sufficiently moved the infusion of senna with Epsom 
salts sufficed. The general disquiet of the system was often 
thus relieved, and the skin obviously loosened and moist for a 
considerable length of time. But to augment the last-named 
result and to get a full febrifuge effect, I gave, with as little de- 



USES OF SPIRITUS MINDEREM. 137 

lay as possible, the spiritus mindereri. In some cases I found it 
useful to add tartar emetic to the mixture. This was specially 
indicated by the presence of a good deal of arterial excitement, 
and was found to be a safe substitute for the lancet. My com- 
mon formula was thus : — 

R. — Acet, distill, ^iv; 

Carb. amnion, q. s. to neutralize. 
Add to the solution 

Tart. emet. gr. i. 
Mix. Give a tablespoon half full. 

By the use of this or a like mixture for two or three hours a 
very copious perspiration was generally secured, with sensible 
relief of all unpleasant symptoms ; and during this state of 
things the administration of the sulphate of quinine was com- 
menced. In the region round about Philadelphia, in the period 
above named, it was not necessary to employ this unequaled 
antiperiodic as it has been since exhibited in other places. My 
usual practice for an adult case was to mix ten grains of the sul- 
phate with half that quantity of powdered ginger, and to divide 
into four parts, one of which was given every half hour in syrup 
or sweetened water. The appearance of moisture, even though 
the skin was rather hot, was the evidence of actual remission, 
and justified the use of the sulphate. It was deemed an unwise 
course to wait for total absence of heat, or, in other words, for 
an intermission, since that is no part of a remittent. The mo- 
ment I saw an evident abatement there was remission enough to 
warrant the use of the antiperiodic power of the salt of quinine. 
My theory and my practice, and the issue, all harmonized here 
most perfectly, for I never in my whole medical history have 
witnessed as perfect a triumph of medicine over disease as I saw 
for weeks and months in this procedure in the treatment of bilious 
remittents. 

The grand error then perpetrated by many physicians was to 
abstain from the use of anything like a tonic or antiperiodic 
because the tongue was not quite natural, the skin too hot, the 
liver not sufficiently active, &c. The practice corresponding 
with this error was to repeat cathartic doses more and yet more 
drastic, in the hope of cleaning the tongue and rousing the liver. 
The strength was all the while rapidly waning, and a true typhoid 
state of the system induced, which, after continuing for weeks, 
ended in death, unless the inherent energy of a good constitution 
triumphed over the folly or madness of the doctor. 

Very many of the so-called congestive fevers of the South-West 
were induced, as I have had palpable evidence, by such a course 
of professional mismanagement as that to which allusion has been 
made in the foregoing remarks. 

g 8 10 



138 USES OF SPIRITUS MINDERERI. 

In the treatment of cynanche parotidea, or mumps, I have 
found the spiritus mindereri an excellent medicine. This dis- 
ease is for the most part a very manageable affair, and rarely 
presents an unpleasant aspect, unless rudely managed. The 
chief embarrassment grows out of metastasis to the testicles, 
mammary glands, or to the brain, and these are found most fre- 
quently in connection with over'-vigorous treatment. Such at 
least has been the result of my observation. 

I have seen the mumps extensively prevalent in medical classes 
in Ohio and Kentucky, and my customary plan has been to 
administer the emeto-cathartic of calomel and jalap at once, as 
already indicated in my remarks on bilious remittents. This is 
followed by the spiritus mindereri, so as to keep up a moist state 
of the skin ; and the same mixture is applied on flannel to the 
swollen throat, where it acts as a gentle discutient. 

In a French medical journal mention is made of the happy 
use of this medicine in the treatment of uterine cancer. Table- 
spoonful doses were given in a wineglass of gruel or gum-water, 
and repeated every hour. The late Professor Eberle was par- 
tial to a like practice in dysmenorrhea. In both cases the local 
distress was greatly relieved, and the medicine acted freely as a 
diuretic. 

Boerhaave treated opacity of the cornea with a mixture of 
equal parts of spiritus mindereri and water dropped frequently 
into the affected eye. A collyrium is sometimes used in sub- 
acute ophthalmia, made of the spirit and rose-water, equal parts, 
with the addition of a small quantity of an opiate. The follow- 
ing prescription is more common : — 

R. — Spt. mindereri, ^ss ; 

Aq. rosar. gij ; 

Aquas pur. gij ; 

Acet. morph. gr. ij. 
Mix. 

As an external application the spiritus mindereri has been 
successfully tried in tinea capitis, after poulticing to remove 
scabs and cleanse the surface. But neither this nor any other 
lotion or appliance will avail in scald head, unless special care 
be paid to the condition of the digestive organs. 

The incompatibles of acetate of ammonia — the salt which con- 
stitutes spiritus mindereri — are the acids, the fixed alkalies, alum, 
lime-water, sulphate of magnesia, corrosive sublimate, nitrate of 
•'silver, sulphates of zinc, copper, and iron. 

The phosphate of ammonia, a compound of phosphoric acid 
and ammonia, is an old medicine which has lately been revived, 
chiefly for its importance as a remedy for rheumatism and gout. 
In Ranking 's Abstract, No. vii. p. 72, are some very good prac- 



USES OF PHOSPHATE OF AMMONIA. 139 

tical suggestions by Dr. Edwards, who has employed it in the 
above diseases with very pleasing success. In some instances 
the effects were almost magical, so promptly did the patients re- 
gain the power of easy locomotion. 

In the Philadelphia 31edical Examiner for August, 1846, we 
have the experience of Dr. Hartshorne in the use of the phos- 
phate in rheumatism. The doses employed varied from ten to 
thirty grains, three times a day. In all the cases reported de- 
cidedly sudorific and antiphlogistic measures were also employed 
at the same time. The phosphate of ammonia probably acted, 
in part, by eliminating the materies morbi — which some writers 
regard as uric acid and the urates — by the bladder, as it mani- 
festly augments the urinary discharge. It may be given in 
water, or in a bitter infusion, as of serpentaria. 

The first physician who noticed the use of this salt in gout 
and rheumatism was Dr. Buckler, of Baltimore. His paper 
appeared in the Amer. Journ. Med. Sciences, Jan. 1846. He 
added sometimes half an ounce, and occasionally an ounce, of the 
phosphate to six ounces of water, giving a tablespoonful of the 
mixture every four hours. He affirms that obvious relief ensued 
in the course of thirty-six hours. He thinks the remedy acts by 
decomposing the urates and eliminating the uric acid from the 
blood and urine. (See Braithwaite s Retrospect, part xiii.) I 
have tried this plan, and am pleased with it. 

The hydro sulphur et of ammonia has had some reputation as 
a remedy for diabetes mellitus. It is made by passing sulphu- 
retted hydrogen gas into the water or spirit of ammonia. It is 
an exceedingly offensive liquid, having an odor nearly as odious 
as rotten eggs. It has been held to be a direct sedative, induc- 
ing drowsiness, vertigo, nausea, and even vomiting. Cruikshank 
first employed it in the disease above named for the purpose of 
lessening morbid action of the digestive organs. The dose was five 
drops in a tumbler of water three or four times a day, gradually 
increasing the number of drops daily until some vertigo ensued. 

The valerianate of ammonia (composed of valerianic acid 
and ammonia) has been highly commended by Dr. Declat as a 
remedy for facial neuralgia. The preparation he employed 
was a brown liquid, not very limpid, of disagreeable taste, and 
smelling strongly of the valerian. Ordinarily the dose was a 
teaspoonful, but he has given two and even three at a dose. In 
his own person the medicine induced all the desirable sedative 
effects of opium apart from the cerebral inconvenience result- 
ing from the use of that drug. He tells us that the preparations 
of the article vary, and that some standard of uniformity is 
greatly needed. Of course this remark is just. — Brit, and For. 
Med. Qhir. Rev. Jan. 1857. 



140 AMYLENE. 

Ammoniac G-um. G-um ammoniac — obtained from the Hera- 
cleum gummiferum of Africa. — This article is introduced just for 
the purpose of making a remark which I have often uttered, viz., 
that it is one of the most worthless articles in the Materia Medica, 
never having done a particle of good unless compounded with 
other agents of acknowledged power. It has been called a 
stimulant, an expectorant, an antispasmodic, an emmenagogue, 
&c. &c, but should never be allowed a place in any physician's 
shop. 

Amygdala. Almonds — bitter — sweet. — The former contain 
some hydrocyanic acid. The sweet almonds are employed in 
medicine mainly for the purpose of forming emulsions. They 
have a demulcent property, and are therefore used as demulcents 
generally are, both in the form of infusion for drink and also 
for injections. The oil of almonds is bland and pleasant, but 
possessing no very valuable medicinal properties. 

Amylene. — This is the name given to a new anaesthetic agent, 
obtained by the distillation of fusel oil and chloride of zinc. 
This product has been known to chemists for about fifteen years, 
although very little has been said about it in the journals. It is a 
very light, volatile liquid, the vapor of it being much less pun- 
gent than that of chloroform, although the patient must inhale 
a larger quantity in order to induce the desired effect. 

Amylene has been tried successfully in a good many surgical 
operations in King's College Hospital, London. Pain was en- 
tirely prevented, and recovery ensued without the occurrence of 
nausea, the patients being in a state of semi-consciousness. 

"Last week," says the Lancet, "a patient aged thirty-three 
was operated upon for fistula in ano, by Mr. Fergusson. Pre- 
vious to the operation amylene was administered by Dr. Snow. 
Unconsciousness was produced in two minutes, and the operation 
quickly performed, the anaesthetic being inhaled altogether three 
minutes. The pulse ceased during the operation, but respiration 
continued for at least ten minutes afterward. The patient 
moved after the pulse ceased, and gave signs of rallying. These 
symptoms proved, however, fallacious, and he died in a few min- 
utes. On examination, there was found slight dilatation of the 
right ventricle of the heart ; the lungs were emphysematous. 
Dr. Snow concludes that death resulted from the amylene, the 
condition of the lungs probably tending to the fatal result. This 
case was the 144th in which Dr. Snow had administered amylene, 
and on no other occasion was its employment attended by the 
slightest ill consequence." 

Dr. Tyler Smith says the amylene should always be given by 
means of an inhaler, and not with a mere piece of lint. How- 
ever well the latter may do for chloroform, it is not the thing for 



ANIMAL POOD. 141 

amylene. Dr. Smith says he has used it in midwifery practice 
with success. 

M. Giralds states, (in the Med. Times and Grazette, April 4, 
1857,) as the result of using amylene in place of chloroform in the 
cases of twenty-five children of different ages, that he reached 
the following conclusions : — 

1. It is respired more easily and with less struggling than 
chloroform. 

2. Anaesthesia takes place very quickly. 

3. Sleep is more calm and natural, being unattended with 
stertor. 

4. The patients return rapidly to the normal state. 

5. It does not induce nausea, vomiting, nor cerebral con- 
gestion. 

6. The patients suffer no inconvenience afterward, recovering 
all their wonted sprightliness. 

Amylum. Starch — the fecula of wheat, &c. &c. — This is de- 
mulcent, and is often useful in form of injection, to relieve the 
bowels and bladder when laboring under irritation. A starch 
enema is a good vehicle for the administration of laudanum per 
anum when it cannot easily be introduced by the mouth. Two 
or three drachms of powdered starch boiled in a pint of water 
till the whole is dissolved will make a proper article for this 
purpose. Two or three ounces of the solution, with from twenty 
to sixty drops of laudanum, will often be retained if thrown into 
the rectum carefully, and will accomplish all that could be de- 
sired from the use of opiates by the mouth. If the lower 
bowels are not in an irritable condition a half-pint of the solu- 
tion can be easily retained. 

Animal Food. — The importance of sound and well-cooked 
animal substances is now almost universally conceded. In the 
article on Diet we have been somewhat particular on this subject, 
and propose now to notice, briefly, the changes which those sub- 
stances undergo that render them insalubrious. 

By some process not by any means understood certain animal 
matters are so changed, although their exterior may appear as 
usual, that the eating of them gives rise to very distressing 
symptoms, and sometimes causes death. Some have supposed 
that there is carried on silently and imperceptibly a modified 
putrefaction, which changes the quality without affecting the 
form or apparent condition. The articles most usually altered 
in this or in some other way are sausages, lard, pork or bacon, 
and butter.* 

* It may be a matter for serious study whether the disease called hog cholera, 
■which has killed so many hundred hogs in the far West during the last year, 



142 POISONOUS ANIMAL SUBSTANCES. 

The poison of sausages has become so notorious in some parts 
of Europe as to have been the subject of a thesis, a prize essay, 
and other papers. In the Wirtemberg territories, in Germany, 
we are assured that two hundred and thirty-four cases of this 
kind of poisoning occurred in about thirty-four years ; of which 
number one hundred and ten proved fatal. In the winter and 
spring of 1834, similar cases occurred in the neighborhood of 
the Black Forest, in the territories above named. The symp- 
toms are reported to have been very alarming, and several indi- 
viduals died. The food eaten by these persons was the sausage 
of the country and liver puddings. The former was reduced 
to a pulp in the centre, was very bitter and rancid, and smelled 
like cheese. The puddings had been evidently decomposed, as 
they were quite sour. The remedies found most successful in 
these cases were immediate vomiting, a purgative draught of 
Glauber salt, and clysters of vinegar and soap. 

It is stated by various writers that the symptoms of sausage- 
poisoning do not begin until twenty-four hours after the noxious 
meal has been taken. This is said to be owing to the great indi- 
gestibility of the fatty matter which enters the food. Pain in 
the stomach, vomiting, purging, dryness of the mouth and nose, 
are usually the first symptoms. The eyes and eyelids, and next 
the pupils, become fixed and motionless ; the voice fails, or is 
entirely lost ; deglutition is difficult ; the pulse gradually sinks ; 
frequent swoonings come on, and the skin becomes cold and in- 
sensible. The bowels are sometimes torpid, at others the very 
reverse. The appetite is not impaired, there is little or no fever, 
and the mind maintains its usual tone. Fatal cases end with 
convulsions and great difficulty of respiration between the third 
and eighth days. Such is the shock imparted to the system that 
even in successfully treated cases the effects are felt for years. 

The morbid appearances in the dead body are inflammation 
of the mucous membrane of the stomach and. bowels, whiteness 
and dryness of the throat, thickening of the gullet, croupy de- 
positions in the windpipe, great flaccidity of the heart, and a 
morbid tendency to resist putrefaction. 

What is the nature of the change effected in the sausage no 
one has been able to reveal. It has been asserted that the poi- 
sonous principle resides in a fatty acid, called by Buckner the 
botulinic acid. Experiments with this acid, as obtained from 
the spoiled or poisonous sausage, showed the same results as are 
witnessed in animals that partake of the sausage itself. 

In regard to the poisonous quality of lard under peculiar cir- 

may not entail on our citizens all the consequences that flow from eating 
poisoned pork. It is said that many of the animals sick of the disease above- 
named, were killed and cured in the usual way, for transportation. 



POISONOUS MEATS. 143 

cumstances, we have little to say that is satisfactory. Mere 
rancidity does not seriously affect it. Keeping it in copper or 
leaden vessels may render it more or less deleterious. 

In the winter of 1838-9, I saw a portion of lard sent to Pro- 
fessor Peter for examination in consequence of having sickened 
those who partook of it in any shape. Some were affected pretty 
severely, though no one died. The lard looked as well as usual 
and had no particular smell or taste. The examination failed to 
detect anything of a poisonous nature. It is quite possible that 
lard may be poisoned by the empyreumatic oil, resulting from 
the application of a strong heat to a small portion of it. It is 
known that this oil as produced by the destructive distillation 
of lard is decidedly poisonous. Five drops passed into the 
throat of a bird nearly killed it. 

Pork in the fresh as well as the cured state, under the name 
of ham, bacon, &c, has often evinced poisonous properties. I 
am of opinion that some of the cases of poisoning, as they are 
termed, by fresh pork, were dependent on other causes. In the 
summer season, when green or ripe fruit is freely indulged in, 
almost any kind of fresh meat, not well seasoned, will derange 
the digestive apparatus ; and it has frequently occurred that true 
and fatal cholera morbus has resulted from such imprudence. 

In the Philadelphia Medical Examiner for January, 1839, 
we have a short paper headed "Poisoning from pork" furnished 
by a physician of Illinois. The patient died, it is true, but he 
had been laboring for months under gastro-enteritis, was fre- 
quently attacked with colic, and often much disturbed by any 
sort of food that did not suit his condition. Under these cir- 
cumstances fresh pork was freely eaten, and soon after a 
quantity of grapes, and the man died in nine hours from the 
commencement of the attack, which did not begin until the day 
after the pork meal. 

I will not say, however, that young pork may not acquire a 
poisonous quality, and kill as the consequence; but the cases 
that I have met with are not satisfactory. 

In reference to ham and all kinds of bacon the evidence of 
occasional poisoning is conclusive. This may be the result of 
very different causes. The meat may be poisoned in the act of 
smoking it, as is known to have happened to certain soldiers in 
Corsica, who smoked their meat with mezereon and other woods. 
In the careless manner of gathering rubbish for this purpose 
many poisonous articles may be accumulated and the meat may 
thus be effectually poisoned. 

The more common source of poisoning in bacon, however, is 
doubtless the same fatty acid that renders sausages so delete- 
rious in some vicinities and in certain seasons. 



144 POISONING BY BACON. 

The history of a family poisoned by eating a ham-pie made at 
a Parisian pastry-cook shop is deeply interesting. The examina- 
tions made by Ollivier and Barruel to detect some kind of me- 
tallic poison totally failed, and the able chemists were forced to 
the conclusion that the meat had experienced a change similar 
to that which gives a poisonous quality to German sausages and 
ham. 

In three hours after dining on the ham-pie the master of the 
house was seized with general uneasiness, cold sweats, shivering, 
violent gastric pains, frequent vomiting, burning thirst, extreme 
tenderness of the abdomen, profuse purging, and very violent 
colic. The poison was evidently of the irritant class, as the 
same symptoms attacked a daughter aged twenty-seven and an- 
other aged nine. The physician who was called in supposed 
that verdigris or some other salt of copper had been communi- 
cated by the pastry-cook's copper moulds. By a vigorous 
course of treatment the patients recovered. The plan pursued 
is not stated. It should be borne in mind, however, as a reason 
for suspecting a copper poison, that the alvine discharges were 
as green as the common house-leek. 

Dr. Geisler has given, in Horn's Archives for 1828, the ac- 
count of a family of eight persons evidently poisoned by bacon. 
Their symptoms, with the addition of delirium and loss of recol- 
lection, were the same with those resulting from the sausage 
poison. A remarkable circumstance in this history is that the 
father escaped unhurt, "having stewed his bacon, while the rest 
ate it raw." It is supposed that the process of stewing dissipated 
or decomposed the fatty acid so as to render it harmless. 

In the London Medical Grazette, vol. xix. p. 378, we have the 
case of a family poisoned by bacon, or rather several members 
of the family. All who partook of the meat were sickened, and 
one of the children died after severe gastric and intestinal dis- 
tress which continued for more than three weeks. Severe 
spasms and violent retching, with dreadful headache, were the 
attendant symptoms. Post-mortem examination revealed exten- 
sive gastric ulceration. 

The difficulty of deciding satisfactorily as to the true source 
of poisoning in animal matters has been alluded to. We may 
remark further that many families have been sickened and some 
persons fatally poisoned by eating the meat variously cooked of 
animals that had sickened and died. The symptoms in these 
cases are those of irritant poisoning, such as gastric pains, 
vomiting, severe colic, diarrhoea, &c. &c. In all these cases it 
is quite probable that the fatty matter of the animal experiences 
a change such as occurs in the German sausage, though this is 
only a conjecture. It would seem that the proper course of 



POISONED BEEF. 145 

treatment would be to dislodge the meat from the stomach and 
then to allay the irritation by means of anodynes and rubefa- 
cients, blisters, &c. to the epigastric region. 

In several New York papers for January, 1842, we noticed 
substantially the following statement, the relation of which to 
the foregoing remarks is sufficiently obvious : — 

"A large number of persons [forty-one in number) became 
suddenly sick in the upper part of the city of New York a few 
days ago ; and from the fact that this number in the same neigh- 
borhood had thus been stricken down with disease at or about 
the same time, the city authorities considered it their duty to 
institute an investigation into the circumstances with a view to 
the discovery of the cause, if any existed out of the natural order 
of things. The mayor has accordingly given notice that the 
cause of the sickness proceeded from the eating of smoked beef 
by the individuals attacked, which, on examination, was found 
to have a bluish, unhealthy appearance, and is supposed to have 
been made of some animal that had died of disease. It is conjec- 
tured that, in putting up the meat, some kind of poisonous drug 
has been used instead of saltpetre. The persons now lying dan- 
gerously ill were attacked with chills, which terminated in severe 
vomiting and unusual pains of an excruciating character." 

The proper treatment in the cases above detailed is to evacuate 
the contents of the stomach at once, to give a mild purgative 
draught of Epsom or Glauber salts, and clysters of vinegar and 
soap. The latter may be made of three or four ounces of soft 
soap, two ounces of vinegar, and four of water. Sometimes it 
may be needful to blister the epigastric region and to give gentle 
anodynes. 

The French Journal of Pharmacy and Chemistry for August, 
1842, gives an account of nearly six hundred persons poisoned 
by partaking of a feast in which veal in the incipient stage of 
putrefaction was largely employed. The symptoms were a com- 
bination of those attendant on irritant and narcotic poisons, and 
death ensued in many cases. The great prostration of the 
patients gave a close resemblance to cases of typhus fever ; and 
some of the nurses are reported to have caught a like disease 
from the patients. 

Effects somewhat similar, though not with fatal results, fol- 
lowed the eating of a roebuck, killed after a violent chase in 
which it was exceedingly terrified. 

The JEdinb. Med. and Surg. Journal for July, 1842, has 
furnished some interesting particulars of poisoning by a heifer 
affected with carbuncles. Sixty persons ate of the meat, and all 
were attacked with giddiness, tremblings, shiverings, severe 
cramps, vomiting and purging of green bile, intense thirst, 



146 ANAESTHETIC — ANTACIDS. 

sunken countenance, delirium, with the tongue red at the tip 
and furred at the base. All recovered under the use of simple 
means, save one. In this case, the symptoms were most severe. 
The body was much wasted, and covered with livid spots. 

Anaesthetic. — This term is of Greek origin, and means, lite- 
rally, loss of feeling. Unconsciousness is frequently an attend- 
ant of the state of anaesthesia, to induce which inhalations of 
chloroform and sulphuric ether are resorted to. 

In addition to the use of these agents in obstetrical cases and 
in surgery, they have proved salutary in rheumatic disease. Dr. 
Aran applies them directly to the joints affected, on a moist 
compress, renewing them every twenty-four hours, or oftener if 
needful. He prefers the Dutch liquid (chloride of defiant gas) 
to all other articles. — London Medical G-azette, December, 1850. 

Anodyne. — This term is introduced here in order to correct 
erroneous impressions. It means, truly, any agent that will 
secure sleep or quiet repose by mitigating or annulling pain. 
By many, the word anodyne is made synonymous with some form 
of opiate. But a very little reflection will show this to be a 
mistake. A bleeding from the arm, or cups to the neck or head, 
will sometimes give hours of sweet sleep, by relieving the patient 
of severe pain of the head. The remedy is obviously an anodyne, 
and in just such a case opium would probably do mischief. A 
female has lost several nights' rest by an inflamed breast, threat- 
ened with abscess, and so soon as a fly-blister has begun to act 
fairly on the surface the woman falls asleep. I have witnessed 
this more than once, and saw plainly an anodyne result. Ice 
applied to the head is often a most delightful anodyne. 

Antacids. — This term seems to be sufficiently significant. It 
indicates any remedy to prevent or cure acidity anywhere. The 
alkalies and alkaline earths being chemical antagonists of the 
acids, are therefore the leading antacid agents; such as mag- 
nesia, lime-water, the carbonates and bicarbonates of potash and 
soda. 

The medical mind has imbibed the notion that to prevent or 
cure acidity the patient must avoid acids and employ alkaline 
articles more or less. This is a very restricted view of the 
subject. A generally atonic state of the whole system, and 
especially a long-continued defect of tone in the stomach, will 
often of itself engender a morbidly acid state, which is curable 
by the tonic power of the milder acids more certainly than by 
any other means. This has been tested in my own person, and 
in other cases, most abundantly. Long-continued acidity, 
dependent on defective tone, has been cured over and over again 
by the use of lemonade, and even unmixed lemon juice. A 
very good paper was published, not long since, in one of the 



ANTAGONISM OF POISON AND DISEASE. 147 

American journals, showing the efficacy of sour buttermilk in 
dyspepsia and chronic diarrhoea ; and I have no doubt that the 
principle involved was precisely the same as that herein illustrated. 

Antagonism of Poison and Disease. — I have chosen the 
caption prefixed to these remarks because of its brevity rather 
than for its explicit character. The point to which I desire to 
call attention specifically is one that has entered into my public 
teachings for several years ; and I am free to confess that I do 
not yet comprehend it fully. I refer to the fact, about which 
there can be no difference of opinion, (I mean as to its existence,) 
that decidedly poisonous doses, so far as bulk or weight was con- 
cerned, have been frequently swallowed without material injury, 
and that, too, independently of any condition of the stomach 
sufficient to account for the result. The doctrine that has ap- 
peared to me as the true solution of the problem is, that in the 
most striking cases on record the otherwise poisonous dose has 
spent its force on the morbid action present in the system, what- 
ever that may have been, and in this way its legitimate character 
has not been developed. I have not met with a single direct 
reference to this view of the case anywhere excepting in a short 
article lately published by Dr. Beck, in which there was an inci- 
dental allusion to it. 

I am well aware of the effects of habit in controlling the mis- 
chievous action of poisons so as to render them quite harmless ; 
but I have no reference to this agency on the present occasion, 
for that could not meet the difficulty. 

The case most familiar to the profession, illustrative of the 
doctrine, is the administration of very large doses of tartar emetic 
in the treatment of pneumonic inflammation. Here the dose is 
often so great as to be exceedingly hazardous if its operation 
were restricted to the stomach. The idea of tolerance is asso- 
ciated necessarily with the fact that some other organ besides the 
stomach is to participate in the agency of the remedy; that 
other organ is the lung, which feels the influence of the medicine 
in its restoration to the condition of health. Now, although we 
cannot demonstrate all this just as if it were a problem in Euclid, 
we are compelled to believe that the salutary influence of great 
doses of tartar emetic in this disease involves the principle which 
it is our purpose to illustrate. We do not desire to be under- 
stood here as advocating this plan of curing pneumonia, but sim- 
ply as attempting to account for the result by the obvious an- 
tagonism of disease and poison. 

The modern use of mammoth doses of nitrate of potash is 
another case in point. Every reader of the journals has learned 
that this medicine has been employed in doses of two drachms, 
and even a half-ounce, without developing the smallest evidence 



148 ANTAGONISM OF POISON AND DISEASE. 

of poisonous action. So generally has the deleterious quality 
of nitrate of potash been associated with even two-drachm doses, 
that some have objected to potash as an antidote to nitric acid 
because a poisonous salt must needs be formed in the stomach. 
In acute rheumatism, in hemoptysis, and other diseases, the great 
doses fail to exert a toxicological agency simply by reason of 
the medicinal power acting wholly on the morbid action present 
in the system. It is remarked by Pereira, "that peculiarities of 
constitution and morbid conditions of the system (especially 
affections of the stomach) are principally concerned in modify- 
ing (whether increasing or diminishing) the tolerance of this salt." 
(Vol. i. page 424.) * 

It may be impracticable to explain how these large doses spend 
their force on the morbid action rather than on the stomach. 
Some of the late speculative writers have suggested the idea that 
all medicinal agents are negatively or positively electric, and 
that affinities, attractions, and repulsions, are modified by the 
varying influence of these opposite states. But this suggestion 
does not meet the case, and all we certainly know is the naked fact. 

A case was reported in a foreign journal some years since of 
a woman who had a dropsical husband whose long-continued in- 
disposition had become exceedingly burdensome. She resolved 
to get rid of him, if possible, by administering an ounce of tinc- 
ture of digitalis. The quantity was large enough, as every one 
knows, to kill or greatly injure an ordinary patient. But the 
wife was sadly disappointed, as the intended poison effected an 
entire evacuation of the effused fluid and a most unlooked-for 
recovery ensued. The fact is not isolated, for others of a similar 
character have been recorded. 

What shall we say in attempting to analyze the case ? Is it 
not apparent that there was really and truly an adaptation of 
the poisonous dose to the existing morbid condition, and does not 
the fact clearly illustrate the doctrine of antagonism ? 

The well-authenticated agency of tobacco as an antidote for 
the poison of arsenic, or rather as a remedial agent, is explica- 
ble on the same ground precisely. The cases reported were 
females, who had never indulged in the use of tobacco. A por- 
tion of the arsenic, fully sufficient to kill under ordinary circum- 
stances, was counteracted by the use of tobacco, and without any 
emetic action. What were the facts as regarded the pathological 
condition of the stomach ? The arsenic had commenced its ap- 
propriate action beyond doubt, as the symptoms evinced ; there 
was very probably set up true inflammation, such as arsenic is 
competent to establish. How then were the patients saved? 
The tobacco was given in strong infusion, expressly with the de- 
sign of vomiting and so dislodging the poison. But the emetic 



ANTHELMINTICS. 149 

action failed entirely, and yet the patients were restored after 
comparatively little suffering. 

I know it has been said that the arsenic and tobacco formed a 
neutral mixture in which the poisonous property of both articles 
was lost or nullified. But it is more probable that the intrinsic 
character of tobacco failed to display itself because its power was 
spent on the existing morbid condition of the stomach and bowels. 

In offering these remarks and cases on the antagonism of 
poison and disease, I am anxious to correct erroneous impressions 
regarding the effects of very large doses of medicines of an active 
nature. It is too common, when these doses fail to poison, even 
though a curative result follows, to attribute the absence of 
poisonous symptoms to defect in the remedy as occasioned by 
original impurity or bad preparation. These no doubt often 
seriously affect the therapeutic application, and merit attention. 
Yet it is true that defective observation suffers palpable results to 
be overlooked, which, when properly analyzed, not only fail to 
show any defect in the quality of the remedy, but prove most 
conclusively the doctrine of antagonism of poison and disease as 
herein set forth. To this subject we particularly invite the atten- 
tion of our brethren. 

Some may be ready to infer that I have forgotten the opinion, 
often advocated, that many forms of disease are products of a 
veritable poison the precise nature of which is unknown ; and 
that in this view of the matter it would be more philosophical to 
speak of the antagonism of poison and poison. But if this be 
correct, and we do not say it is not, the same remark would 
apply to every case of disease for which we exhibit active remedies, 
as nearly all our energetic medicines are, in a certain sense, poisons. 

Our main design, however, refers to the cases in which poison- 
ous doses (in the ordinary acceptation) have been taken not only 
without fatal result, but with the effect of curing the patient of 
alarming disease.* 

Anthelmintics. — This term denotes all those means, external 
and internal, that dislodge worms from, or destroy them in, or 
prevent their propagation in the stomach, alimentary canal, or else- 
where. Much diversity obtains as to the agency of worms in the 
human system. Some physicians seem to regard them as always 
pernicious, while others view them as a wise provision, now and 
then at least, for the removal of offending matter. That worms 
are sometimes a source of injury and suffering is beyond all 
doubt a well-established fact ; but they are often suspected as the 
cause of evils with which they have no sort of connection. Well 

* Quite recently a physician has professed to prevent smallpox by adminis- 
tering vaccine virus internally. He supposes the vaccine to be a modification of 
the poison of the variolus, and that it operates on the principle of counter-poison. 



150 ANTHELMINTICS. 

authenticated cases are on record of troublesome cough of weeks 
continuance kept up and originated by maggots of the common 
fly. Elliotson gives some interesting facts in point. Dr. Good 
tells of a flesh-fly, (musca cibaria,) or the larva of it, discharged 
by active purging, after having occasioned much derangement of 
the whole system by sympathy with the alimentary canal. The 
intestinal irritation caused by worms and transmitted to other 
and distant parts frequently does great injury to the system. 
In CooJce's Morgagni, vol. i. p. 285, and in the Amer. Journ. of 
Med. Sciences for Jan. 1845, we find notices of pleurisy evidently 
induced by this kind of irritation. In the last-named journal 
for October, 1843, we are told that epilepsy was manifestly set 
up in the same way, and ultimately cured by vermifuges, and 
that incontinence of urine had been successfully treated with 
anthelmintics, thus justifying the belief in the origin of that 
disease in worms. The JEdin. Med. and Surg. Journal for 
April, 1843, gives a case of severe constitutional irritation in a 
child eighteen months old induced by worms. The discharge of 
five hundred and ten lumbricoid worms in the course of eight 
days left the child well. Fothergill, Quin, and others have made 
it appear, quite satisfactorily, that the disease usually called 
hydrocephalus internus has also had a verminous origin ; and 
the celebrated oculist, Mr. Ware, taught that severe ophthalmia 
had been established by the same agency. A remarkable case of 
this sort is also furnished by Chamberlaine in his book on cow- 
hag e as a vermifuge. 

But why should any hesitate to credit statements like the 
above, when every one knows that worms in the alimentary canal 
have repeatedly induced high fever, delirium, and convulsions ? 
I do not know of any infantile distress more alarming than I 
have repeatedly witnessed from the sympathetic irritation of 
worms. The subject, therefore, is highly important to the prac- 
titioner. It is recorded of an old physician that in every doubt- 
ful case of disease in young children he always resorted to some 
kind of anthelmintic treatment, and with very general success. 

A worm or other insect, no matter how small, getting into the 
nostrils or into an ear, will often set up severe irritation, calling 
for immediate aid. If not properly treated high constitutional 
distress may ensue, with fever and all its train of ills. It is not 
known to every one that an accident of this sort happening to 
the ear is promptly removed by pouring sweet oil into the exter- 
nal meatus. The insect is instantly dislodged, and the pain ceases. 

Mothers suspect the presence and agency of worms if a child 
has habitually a bad breath with a tumid abdomen, the tongue 
furred, the eyes heavy, the lips pale and swollen, itching of the 
nose, evinced by constant picking at the nostrils, heat and irri- 



INTESTINAL WORMS. 151 

tation at the verge of the anus, &c. All these may be present, 
and yet no worms be in the canal ; yet such are the usual attend- 
ants of worms in that region. The physician looks for febrile 
manifestations if worms be really troublesome ; he finds ir- 
regular appetite, costiveness or diarrhoea, a loathing of food, 
and sometimes nausea and vomiting, more or less cough, palpi- 
tation, headache, convulsions, grinding of the teeth. All these 
belong to the morbid effects of worms. 

The worms that infest the human body are of various size and 
form, and sometimes the most insignificant in point of size do 
great mischief. I knew a lady who suffered terribly for years 
from pain in the frontal sinus, and was finally cured by the dis- 
charge of very small worms from that cavity by the frequent 
snuffing of turpentine. 

The more common worms are, the ascaris lumbricoides ; the 
tcenia, or tapeworm ; the ascaris vermicularis, and trichuris. 

The lumbricoid is. synonymous with the teres, or long round 
worm. Some have regarded it as really the same as the common 
earth-worm, which it certainly resembles. It differs in wanting 
the elevated ring or band so obvious in the middle of the earth- 
worm. The human lumbricoid is from two to fifteen inches long, 
and about as large round as a goose-quill. At the moment of 
evacuation they are nearly transparent, and of a pale-red, but 
soon change to a light-opaque yellow, after death. These worms 
infest the jejunum and stomach chiefly, and are sometimes 
ejected by the mouth. There seems to be in some families a pre- 
disposition to the formation and lodgment of this kind of worm, 
and with a total exemption in regard to the other varieties. 

The tamia, or tapeworm, is also called the lumbricus latus, 
and le ver solitaire, or solitary worm, because generally there is 
but one present at a time. We are told of a lady, however, from 
whom eighteen distinct and perfect tapeworms were expelled, 
This kind of worm is made up of regular parts or pieces, con- 
nected by articulation, the whole ending in a kind of tail. Each 
of these parts has a reproductive power, so that the disease is 
not cured unless the whole be expelled. These worms are some- 
times of great length. Boerhaave speaks of one thirty ells long, 
and the same author says he saw one with 21,600 joints. A 
Dutch peasant is reported to have vomited no less than forty ells, 
or one hundred and twenty feet, at one spell, after taking an 
emetic, and would have thrown up more but he bit the worm off, 
fearing he should puke up all his bowels. The location of this 
worm is generally in the small bowels, where it is so rolled up as 
to give the sensation of a ball rolling from side to side as the 
patient turns in bed. The appetite is rendered very morbid 



152 ORIGIN OF INTESTINAL WORMS. 

by the irritation of this kind of worm, both as to quantity and 
quality. 

The ascaris vermicular is, or maiv-worm, is of a pale-yellow 
color, and when fully grown is about half an inch long and as 
thick as a common thread ; hence it is sometimes called the 
thread worm. This worm is most frequently found in the rectum, 
which it annoys severely. The gut is sometimes nearly filled 
with these worms, inducing a very distressing itching, which 
reaches to the verge of the anus. The human frame is infested 
by this worm more than by all others, and very few children 
are entirely free from them. They excite restlessness and even 
convulsions in not a few instances. 

The triehuris, or long thread worm, is seldom seen in this 
country. 

The origin of worms is a subject often discussed but not easily 
settled. The ectozoa and entozoa theories are direct opposites. 
The former refers to an origin without, the latter to an origin 
within, the body. We believe that worms may be generated 
within, although we believe they are, for the most part, derived 
from an external source. Dr. Duncan and others have furnished 
cases going to prove that worms discharged by vomiting and 
purging were formed by eggs deposited on cabbage-leaves and 
other vegetables taken as food or carelessly plucked and chewed 
while strolling through a garden. In this manner it is alleged 
that the hots of horses are generated — the eggs of the gad-fly 
finding their way into the animal's stomach and ultimately .pro- 
ducing the peculiar worms called bots. It is quite certain, too, 
that the constant use of very bad water will engender worms in 
the stomach and bowels, and that complete recovery has soon fol- 
lowed a change of residence, where pure water was always at 
hand. Mere change of location has thus very speedily relieved 
an entire family from the depredations of worms. 

The fens of Lancashire, in England, have from time imme- 
morial been notorious for tapeworm, and every one concedes that 
the cause is to be found in the locality. Sir John Pringle asserts 
that the lumbrici are very frequent concomitants of the remit- 
tents of all marshy countries. 

There can be no doubt, however, that a state of the stomach 
and bowels may result from bad living or disease, of such a 
nature as greatly to increase the number of worms if not actually 
to give rise to their presence. 

This conjecture is made matter of fact by the well-known 
practice of punishing criminals, in Holland, by depriving them of 
salt entirely. The deteriorating influence thus exerted on the 
mucous tissue results in the formation or development of worms 
to an incredible extent. The digestive powers and the general 



ANTI-INFLAMMATORY. 153 

health alike suffer. On the same principle, any very material 
change for the worse in daily diet may set up worms in those who 
never before felt their morbid agency. A healthy individual was 
sentenced to imprisonment in England who had never known 
what it was to be annoyed by any kind of worm. His diet was 
bread and water, with six ounces of meat twice a week. After 
two years' use of this diet he began to pass large quantities of 
tapeworm, and soon became emaciated and very feeble. He 
continued to pass portions of the worm after his release, but 
never recovered his health. 

The very general prevalence of worms among the lower classes 
is justly ascribed to the constant use of crude and defective food. 
The ravages of worms are nowhere more marked than in the 
West Indies, especially among the negroes who live on plantains, 
yams, and rice, half-cooked or not cooked at all, and deprived of 
animal food, unless it be of the worst kind. It is very rare to 
find a child among them quite free of the influence of worms. It 
is a prevailing opinion that in regions where the people subsist 
largely on animal food tapeworm is seldom troublesome. Hence 
its infrequency in Cincinnati, Lexington, Louisville, &c. 

The various remedies for worms will be noticed in their proper 
places. 

Anthemis Nobilis. Chamomile. The Flowers. — The warm 
infusion is sudorific, emetic ; the cold infusion or extract is tonic. 
A poultice, made by stewing the flowers in strong vinegar, and 
applied hot, is an excellent discutient, and soother of local pain. 

Antidotes. — These are employed to counteract poisons, and 
are usually given to act locally. There are three principal 
varieties, as demulcents, which sheath the irritated surface and 
guard it from further harm ; emetics and cathartics, to get rid of 
the poison by evacuation ; and chemical agents, to neutralize and 
render the poison insoluble in the stomach. We shall have fre- 
quent occasion to notice the individual antidotes. 

Anti-inflammatoky. — This term, which is substantially the 
same with antiphlogistic, has been introduced to the notice of the 
profession chiefly in reference to the action of calomel and tartar 
emetic in the arrest of inflammation and the removal of the 
effusions consequent upon it. There is good reason to believe 
that the repulsion between fibrin and calomel is so decided as to 
create a basis for the exhibition of this medicine, in order to 
arrest that morbid process in connection with which fibrin is de- 
posited so as to interfere with the due performance of organic 
functions. In like manner the persistent use of very small doses 
of tartar emetic, as the sixteenth of a grain, given every twenty 
minutes or half hour, displays a marked and controlling power 
over inflammatory action, and at length puts a stop to it. We 



154 ANTIMONY. 

have seen this most strikingly in affections of the brain, or its 
membranes, (or both perhaps,) that were clearly inflammatory, 
after blood-letting, general and local, had apparently failed to do 
good. On the same principle we have been in the habit of ad- 
ministering to vigorous females just delivered of their first child 
(still-born) a mixture of three grains of tartar emetic in a quart 
of water, to be drank through the day in the dose of a wine- 
glassful every hour, as a preventive of inflammation in the mam- 
mary glands, or to arrest it if already begun. We regard the 
treatment as decidedly anti-inflammatory. 

Antimonium. Antimony, formerly called stibium, and hence 
stibiated tartar, in place of emetic tartar. — The familiar term 
antimonial denotes a medicine consisting mainly of antimony in 
some form of combination or other. Pure antimony, called also 
the regulus, is the basis of some of the most important com- 
pounds in use. The absolutely pure metal has no medicinal property. 

What is called crude antimony, although of a dark-gray, not 
unlike the metal, is a compound of antimony and sulphur, and 
known by the name of sulphur et of antimony. This when 
heated with iron filings is decomposed, and pure antimony is ob- 
tained. This sulphuret was probably the first antimonial medi- 
cine ever known to the world, and the knowledge came by casualty. 
Being procured in large masses, and easily shaped into the form 
of cups and other drinking-vessels, it furnished a substitute for 
the more costly utensils that were afterward introduced. Wine was 
frequently drank from cups so prepared ; and when allowed to remain 
in the vessel over night, or for a given length of time, it was dis- 
covered that the wine had acquired emetic properties, owing, doubt- 
less, to the chemical action of the acid in the wine on the sulphuret. 
This medicinal wine was found to be an efficacious preparation. 

The everlasting or perpetual pills had also an emetic power 
followed by a cathartic action. These pills were made by cutting 
small pieces of the sulphuret of antimony into round balls of the 
3ize of pills. One of these sufficed for a family for many years, 
and even for subsequent families. They acted slowly but effectu- 
ally, and were highly esteemed. It is said that a lady who had 
swallowed a perpetual pill became alarmed at its unusually long 
retention in the alimentary canal, and sent for her physician to 
seek advice. The doctor assured her that there was no sort of 
danger, as he had known that pill a great while, and that it had 
passed through the bowels many hundred times, and would 
certainly find its way out on the present occasion, in due season. 
The sulphuret of antimony is not now employed in medical 
practice excepting as a veterinary article of physic. It has, 
however, been largely appropriated to the manufacture of more 
fashionable antimonials. 



PREPARATIONS OF ANTIMONY. 155 

The glass of antimony — the vitrified sulphuretted oxide of 
antimony — merits a passing notice. It results from the exposure 
of the crude antimony to the joint action of a dull-red heat and 
air. Most of the sulphur of the sulphuret is burnt out, the anti- 
mony is converted into a protoxide which is fused by the heat, 
and when cold presents a vitreous or glassy appearance. It is pro- 
toxide of antimony combined with a variable quantity of sulphur. 

This glass of antimony was long employed for making tartar 
emetic and antimonial wine, or wine of the glass of antimony. 
An ounce of the glass added to a pint and a half of Spanish 
wine, digested for twelve days and filtered, gave an efficient anti- 
monial wine. The same glass, it is said, would serve for the 
repetition of the process almost ad infinitum; not quite the 
truth, however, as must be very obvious. 

The calx of antimony, sometimes named in books of practical 
medicine, was an impure protoxide. Morton employed it, com- 
bined with the powder of chamomile flowers, in the treatment 
of old agues. 

The Kermes mineral and golden sulphurets of antimony are 
not entitled to special consideration. We have no use for them. 

The most valuable of our antimonial medicines is the well- 
known tartar emetic, emetic tartar, antimoniated tartar, sti- 
biated tartar, tartrate of antimony, tartrate of potash and anti- 
mony, patassio tartrate of antimony. The names here given are 
all employed synonymously, the last being the most modern and 
probably the most technically correct. I prefer, however, when 
writing prescriptions, to employ the first in the list. 

Tartar emetic was known to, and described by, a German 
chemist in 1620, and is now regarded as a triple compound of 
tartaric acid, oxide of antimony, and potash. It is readily 
formed by boiling equal parts of cremor tartar and protoxide of 
antimony in four times their weight of water, filtering the solu- 
tion, and evaporating until a pellicle forms on the surface. The 
protoxide of antimony used in this process is obtained from the 
muriate of antimony by the addition of water, and falls to the 
bottom in a white mass, formerly called pulvis algarothi. 

Tartar emetic is soluble in three times its weight of water at 
212°, and in fifteen parts of cold water. The aqueous solution 
is decomposed by several acids, the alkalies, alkaline earths, and 
by all vegetable infusions or decoctions that contain tannin. It 
is the latter agent in various articles that gives them an antidotal 
power, in reference to the poisonous action of overdoses of tartar 
emetic. 

Tartar emetic is not unfrequently adulterated, and it should, 
when practicable, be purchased in the crystalline state. The 
pure crystals are white and inodorous, having a slightly styptic, 



156 USES OF TARTAR EMETIC. 

metallic taste ; exposed to the air they effloresce, and on burning 
coals they are blackened and yield metallic antimony. A solu- 
tion of the pure crystals gives a copious golden-colored precipitate 
with hydrosulphuret of ammonia. If the crystals rapidly deli- 
quesce in the open air it is evidence that other salts are present. 

The bolus ad quartanum of the French, so much employed in 
obstinate quartan agues, was a compound of tartar emetic and 
Peruvian bark, which not only gave intestinal evacuations but 
seemed to control the periodical affection; and yet it is well 
known that a scruple of tartar emetic is wholly decomposed by 
an ounce of the strong decoction of Peruvian bark. I know, 
however, that tartar emetic and sulphate of quinine in combina- 
tion often more effectually arrest intermittents than any form of 
the bark alone. Two grains of tartar emetic may be combined 
with ten of sulphate of quinine, and the whole given in three or 
four hours without inducing vomiting at all, yet with a decided 
antiperiodic result. 

The uses of tartar emetic are very numerous and equally im- 
portant. Properly graded in respect of dose we are able to 
obtain from it very desirable results. In minute portions, as a 
sixteenth or an eighth of a grain, it acts happily on the skin 
very speedily. In rather larger doses it will nauseate, vomit, 
purge, sweat freely, and act as a sedative, very sensibly reducing 
arterial excitement. 

I We call it very properly a nauseant, an emetic, an expecto- 
rant, a sudorific, a rubefacient, a counter-irritant, a sedative, 
and, in very large doses, a poison. 

The following formula is an excellent mode of administration 
in a febrile state with hot, dry skin, and especially so after the 
use of the lancet : — 

R. — Emet. tart gr. i ; 
Nit. potas. gi; 
Rub well together and divide into ten powders. Give one every two hours in 
a tablespoonful of sweetened water. 

The powders so made are decidedly antiphlogistic, reduce the 
pulse, moisten the skin, and increase the urinary evacuation. 
They are sometimes called nitrous, and sometimes antimonial 
powders. When a grain or two of calomel is joined to each 
powder we have the favorite preparation of Rush when he desired 
promptly to touch the gums by a gentle ptyalism. 

When we desire to allay pain and secure ptyalism soon, the 
following will answer well : — 

R. — Emet. tart. gr. ij; 
Calomel, £ss; 
Pulv. opii, gr. vi. 

Rub well together, divide into twelve powders, and give one every four hours. 



USES OF TARTAR EMETIC. 157 

There is no medicine more easily administered to young 
patients than tartar emetic. Dissolved in water it has neither 
taste nor smell, and we have no difficulty with it. One grain dis- 
solved in two or three ounces of water make a mixture of which 
a teaspoonful may be given to a child a year old and repeated 
according to circumstances. 

The tartar emetic dose for adults, as sold in the shops, con- 
sists of six grains in one paper, with directions to dissolve in 
six tablespoonfuls of warm water and take a tablespoonful every 
ten minutes until vomiting ensues. Often the effect will follow 
the second or third dose, and sometimes the whole will be taken 
and no vomiting follow. The diversity depends on the peculiar 
condition of the general system, or of the stomach; and atten- 
tion is demanded to these points in administering tartar emetic 
to adults and to children. 

I have known individuals who, from habit in their own country, 
had always taken the entire portion of six grains at once, and 
who continued the practice here. It is not 'a safe method, and 
may induce severe and even fatal spasms. 

As an adjuvant to squills, gum ammoniac, assafostida, and 
some other articles, tartar emetic is of great value. Hence its 
introduction, by some, into the brown or pectoral mixture in lieu 
of antimonial wine. 

The strong tendency of tartar emetic to run off by the bowels, 
as seen especially in the southern section of this country, and 
the decidedly depressing quality of the remedy when employed 
as an emetic, are features that must not be forgotten by the 
medical practitioner. 

The external use of tartar emetic is often important. We may 
combine it with lard or cerate, and so get a tartar emetic oint- 
ment; or we may add it to a soft and hot Burgundy pitch plaster, 
or we may use a watery solution, or an oleaginous liquid made 
more powerful by the addition of croton oil. To form the oint- 
ment a drachm of tartar emetic may be rubbed with an ounce 
of lard or simple cerate. A cloth being spread with the oint- 
ment so made and applied to the skin will soon set up high irrita- 
tion. In three or four hours the skin will be deeply reddened 
and small vesicles begin to appear. As soon as this state is 
perceived and there is much pain from the application, it should 
be removed, and a soft bread and milk poultice laid on the spot 
and renewed twice a day. The vesicles will soon fill and ulce- 
rate, constituting a discharge or drain from the skin, which is 
often very serviceable, especially in diseases of the chest. One 
advantage of this drain over a blister is its longer duration, as a 
means of counter-irritation and depletion. As the part is apt to 
be marked by scars after healing, it is important to avoid places 



158 ANTIMONIAL WINE. 

that will show these scars in future life ; especially does this 
remark apply to females. 

The pitch plaster is a convenient mode of pustulation. Having 
spread the pitch on leather, and while hot, dust on the surface a 
scruple or two of the tartar emetic, and press it into the pitch 
with a spatula. Heat the plaster gently and lay it on the part 
intended to be pustulated, and manage subsequently as already 
pointed out. 

An excellent plan, however, and perhaps the least troublesome, 
is to employ the following : — 

R. — Antimon. tart, ^i; 
01. olivar. 3;ss; 
" crot. tig. gss. 
Mix. 

Rub a portion of this into the spot by means of soft cotton or 
sponge, night and morning, and lay a piece of flannel on the 
place wet with the mixture. The irritation and vesication will 
soon be obtious, and if not sufficient can be augmented by sub- 
sequent applications. This preparation is very useful along the 
upper part of the spine, to relieve the organs of the chest, labor- 
ing under various forms of disease, calling for decided counter- 
irritation, as, for instance, chronic bronchitis. 

We hinted at the formation of a kind of antimonial wine from 
the glass of antimony, but as the article is made almost exclu- 
sively of tartar emetic, and as when thus made, it is a very im- 
portant medicine, it merits a further notice. It is sometimes 
called the liquor of tartar emetic, though more generally known 
as antimonial wine. This compound differs from the old article 
as made from the glass of antimony in the disuse of the fluid 
commonly called wine. Not a particle of this enters the medi- 
cine now under consideration, as will appear from the formula. 
Two scruples of tartar emetic are dissolved in eight ounces of 
boiling water, and, after filtration, two ounces of rectified spirit 
of wine or alcohol are added, with a view to prevent decomposi- 
tion of the" tartar emetic, which so often resulted from the old 
plan, in consequence of defective wine. The medicine thus pre-, 
pared will remain unchanged, and hence the importance of the 
formula. Each tablespoonful of the solution contains one grain 
of tartar emetic. A fluidounce, containing two grains of the 
salt, of course every teaspoonful or sixty drops, must contain 
exactly a quarter of a grain. We thus know precisely how much 
of an active antimonial we are exhibiting in every dose ; and this 
is a decided advantage over the old preparation from the glass 
of antimony. 

The solution, as prepared above, is colorless, and this too is 
sometimes an advantage, in the case of suspicious patients. If 



ANTIMONIAL WINE. 159 

it is desired to have it more or less colored, this end is readily 
attained by the addition of cochineal or red sanders. From ten 
to thirty drops of the solution will act as a diaphoretic, and after 
the effect begins even five-drop doses will often keep it up if re- 
peated every ten minutes. Added to saline medicines and warm 
drinks the sudorific action is more certain and often more effect- 
ive. Given in doses of a drachm or two it nauseates ; in half- 
ounce to ounce doses it acts as an emetic. These doses are for 
adults, and may be reduced or enlarged to meet the circumstances 
of peculiar cases and constitutions. Sometimes a very small close 
will vomit an adult who at any other time could not be moved by 
a quantity twice or thrice as large. 

When antimonial wine is given to children, as for the relief 
of croup, it now and then sets up long -continued vomiting, or 
irritability, with distressing efforts to throw up. These cases 
sometimes are quite alarming to young practitioners. They 
may be relieved often by exciting the action of the bowels by a 
small quantity of laxative medicine, or by an injection. If the 
irritability still continue, it may be arrested by a dose of lauda 
num, or a little old wine, or very strong coffee without sugar or 
milk, or by laying a small blister over the epigastrium, and on 
the denuded skin a half-grain of the acetate or sulphate of 
morphia, repeating in an hour if necessary. The last expedient 
is the most reliable. 

Dr. Paris has given some important facts touching antimonial 
wine made with common wine instead of alcohol. He was en- 
gaged in an official inspection of the apothecary shops of Lon- 
don, and frequently noticed that the wine was wholly defective, 
all the protoxide of antimony being precipitated. It was ascer- 
tained that inferior wine had been employed, or that which con- 
tained a great deal of tannin, which rendered the mixture inert. 
This development led to the general use of the rectified spirit 
of wine, which wholly prevents the decomposition of the tartar 
emetic* 

Before we dismiss the notice of antimonial wine, or the liquor 
of emetic tartar, it is proper to refer to a most happy and valu- 
able use of it as a sedative, to control undue cerebral action. In 
cases of this kind, over which the lancet seems to have little 
agency, I have seen fifteen-drop doses, repeated every ten or 
fifteen minutes, operate most decidedly for good. It is gene- 

* Antimonial wine should be recently prepared, because all solutions of tartar 
emetic are very liable to undergo spontaneous decomposition. It ought to be 
clear and without deposit. If it has undergone decomposition it will contain no 
antimony, which may be proved by passing through a portion a current of sul- 
phuretted hydrogen gas, or adding a few drops of hydro-sulphuret of ammonia. 
The presence of antimony is proved by the orange-colored precipitate that falls. 
Adulteration of Medicines, p. 37. 



160 CONTRA-STIMULANT USE OF TARTAR EMETIC. 

rally needful, in the case of adults, to persist in the use of the 
medicine twelve, eighteen, or twenty-four hours. The pulse is 
reduced, febrile heat subdued, and the skin kept moist. A 
quantity of tartar emetic equivalent to the antimonial wine 
would answer equally well ; say an eighth of a grain, or even a 
fourth in some cases. 

The same practice has been very successful in Europe as well 
as in this country in obstetrical cases. In the Dublin Lying- 
in Hospital, the long-continued exhibition of tartar emetic, or 
antimonial wine, in the small doses named above, has been re- 
markably useful in rigidity of the os uteri and vagina, in irri- 
table and violent labors, in obstructed or inflamed mammas, 
puerperal convulsions, and mania. The patients should be kept 
under the sedative action of the medicine for twenty-four, and 
sometimes even thirty-six hours. I have found a watery solu- 
tion of tartar emetic, three grains to a quart of water, a most 
admirable medicine for preventing imflammatory action in the 
breast of females after their first pregnancy with a dead child 
and the breasts exceedingly tumid with milk. The solution is 
to be drank in the quantity of a wineglassful frequently in the 
course of the day; or if that sicken the stomach the half may 
be swallowed. It should be continued at least during twelve or 
eighteen hours, and even much longer if the circumstances so 
require. 

A practice very similar is beneficial in the case of old luxa- 
tions, and dropsy of the synovial membranes, where it acts by its 
power as a sedative by promoting the action of the absorbents 
and by its relaxing property. 

The contra- stimulant use of tartar emetic is also important. 
The medicine is not intended to act as an emetic, but accustoms 
the stomach to its irritant action, so that after one or two doses 
the force of the remedy is spent on local inflammation, as in 
pneumonia, where it has been largely employed. This practice 
was frequent in the seventeenth century — fell into disuse, and 
was afterward revived. The effect of the medicine is said to 
be to control local excitement or inflammation, and therefore it 
is virtually a sedative, though regarded as a contra, or counter- 
stimulant. 

Laennec gave forty-eight grains, in divided doses, in twenty- 
four hours, with no vomiting after the first three or four doses. 
Others have given much larger doses than Laennec administered ; 
and to the peculiar state of the stomach, under the influence of 
these doses, they gave the name of tolerance. The idea is that 
the stomach, after a time, tolerates or endures the presence of 
a real emetic without realizing any special discomfort. Rasori 
affirms that he could accustom the stomach to doses of five, 



VEKY LARGE DOSES OF TARTAR EMETIC. 161 

twenty, and even fifty grains, on this principle. The medicinal 
effect was all spent on the inflammatory state of the lungs. He 
gave the remedy thus liberally in lieu of blood-letting, and 
affirmed that he could tell pretty certainly the extent and grade 
of pneumonic inflammation by the quantity of tartar emetic that 
could be borne without vomiting being induced. 

In order to show with what unchangeable hardihood Rasori 
administered tartar emetic, we will give in detail the two follow- 
ing cases: — 

" A young man was received in the clinique of Rasori on April 
5, 1809, who had labored for four days under symptoms of 
pneumonia, for which he had been bled and cupped on the side : 
pulse hard and wiry ; cough, with pain in the right side of the 
thorax. [Bled, tartar emetic 24 grs.) 6th inst., vomited twice. 
[Tartar emetic 48 grains.) Evening: Great augmentation of 
cough and pain; expectoration tinged with blood; pulse vibra- 
ting; six alvine evacuations. [Tartar emetic, 48 grs.) 7th inst. : 
In the morning, {tartar emetic 72 grs.) Evening: Exacerbation 
of fever, of cough, and of pain; frequent vomiting; six dejec- 
tions. (Tartar emetic 72 grs., blood-letting.) 8th day: Same 
symptoms. (Tartar emetic 144 grs., bleeding.) Evening: 
Vomiting, with increase of symptoms. (Tartar emetic 144 grs., 
bleeding.) 9th day : Frequent vomiting ; respiration a little diffi- 
cult; pain moderated; feeling of oppression referred to the epi- 
gastrium; great muscular weakness; skin dry and hot; tongue 
dry. (Tartar emetic 7 '2 grs., blood-letting.) Evening: Repeated 
vomiting. (Tartar emetic 36 grs., blood-letting.) 10th day: 
Vomiting less frequent; the other symptoms continued. (Tar- 
tar emetic 36 grs., blood-letting.) 11th day: Respiration calm, 
no pain, but little cough; the patient could take a full inspira- 
tion, but could scarcely speak ; pulse small, compressible, and 
unequal; skin dry and hot; tongue dry, frequent vomiting, with 
intense thirst. (Tartar emetic 36 grs., blood-letting.) Evening: 
(Tartar emetic 36 grs.) 12th day: (Tartar emetic 36 grs., 
blood-letting.) The patient died the following night. Upon 
examining the body, some hepatization was found in the right 
lung. Everything else was in a state of integrity. 

"Another person, aged 27 years, was admitted into the clinique 
of Rasori April 5, 1809. He had complained for three days 
of pain in the right side of the breast, with cough, spitting of 
blood, and difficult respiration; his pulse was scarcely perceptible; 
heat of skin moderate. It will be unnecessary to give the daily 
treatment of this patient. It will be sufficient to say that between 
the 5th and the 11th of April he was bled ten times and took 
826 grains of tartar emetic. On the latter day he died." Both 
patients were destroyed by the treatment. 



162 TARTAR EMETIC IN DELIRIUM TREMENS. 

There can be no doubt that this heroic practice has often suc- 
ceeded. But I am of opinion that the previous use of blood- 
letting should not be dispensed with, and that less tartar emetic 
will be required to cure pneumonia, if this precaution be ob- 
served. It is doubtful whether more success has attended the 
French and Italian practice than was known to follow the old 
plan of Cullen, in which bleeding, calomel, ipecacuanha, and 
opium, were the prominent remedies. 

It should be borne in mind, too, that this large use of tartar 
emetic has done mischief by setting up ulceration of the pharynx, 
oesophagus, stomach, and bowels; and has sometimes induced 
terribly severe gastric spasms, which compelled the practitioner 
to lay the medicine aside and substitute ipecacuanha in its stead. 

Mr. Milton, surgeon, has shown that tartar emetic is quite as 
useful in inflammation of the cellular tissue near the surface as 
it is in pneumonia. Inflammations of the wrist, gum-boils, 
whitlows, buboes, and the like, yielded rapidly to the remedy. 
He gave it in doses of from a half to a whole grain every two 
hours, and increased the dose as the sickness of stomach sub- 
sided. If the bowels were bound, he gave drachm doses of tar- 
trate of soda at the same time. If the medicine vomited too 
much, he checked this by a half-drop or more of Prussic acid. 
(See London Lancet, May, 1850.) 

Tartar emetic was a favorite remedy for dysentery in 1776, 
as we learn from a paper by Dr. Brown, apothecary to his 
majesty's hospitals in America. He says his medicine produced 
all the good effects said to follow the use of other articles, with 
the advantage of being much more certain and steady in its 
operations. (See Med. Commentaries, vol. ii. p. 406.) 

In the cases just named the therapeutic properties of tartar 
emetic have reference to qualities other than those of emetics 
as such. But when we employ it in delirium tremens, after the 
manner of the late Dr. Joseph Klapp, we expect to succeed 
chiefly in virtue of its power not only to empty the stomach, but 
to correct the morbid state of its mucous coat. It must not be 
forgotten that this medicine is not suited to all cases of this dis- 
ease, and that when it is found in young men who have not been 
long in habits of inebriation a very different plan must be 
adopted. It is in the delirium tremens of old topers, whose 
stomachs have lost nearly or quite all their sensibility, that we 
expect to be successful in the use of tartar emetic. There is a 
total absence of inflammation in such cases, most probably be- 
cause the long use of the stimulus has burnt out the native 
excitability and rendered the organ callous to impressions. 
The mucous membrane is coated with a thick layer of viscid 
mucus, that makes the organ insensible to the action of opiates 



HIVE SYRUP OF DR. COXE. 163 

in the largest doses. Hence it happens that twenty grains of 
opium at one dose fail to procure sleep. 

Facts like these led to the use of tartar emetic to rouse the 
dormant powers of the stomach, to clean off the viscid mucus by 
repeated acts of vomiting, and so present such an improved and 
renovated condition of the stomach as to make it impressible by 
one grain of opium, or even by a teaspoonful or two of fetid 
tincture. 

The design of using the tartar emetic in such cases is, then, 
obviously with a view to its full emetic effect, and I may add that 
it is a safe practice. I mention this circumstance because objec- 
tions have been raised to the potency of the remedy. " You will 
utterly prostrate the system of an old drunkard," says one, 
" by tartar emetic." But from observation and actual practice 
I know that there is no force in the objection. Frequently it 
will be seen that the patient will fall asleep as soon as the emetic 
action has ceased; and, at all events, the opiate dose, though 
small, will effectually secure that desirable result. Should the 
system flag, give a teaspoonful of the milk or tincture of assafoe- 
tida every hour or two, with occasional draughts of some bitter 
infusion, and small quantities of light food, such as the patient 
can most comfortably receive. The volatile julep may also be 
administered, to quiet nervous uneasiness and gently to stimulate 
the stomach and bowels. 

The practice above detailed was very successfully adopted by 
Dr. Klapp, in the old Philadelphia Almshouse, and afterward 
by his nephew, in the Moyamensing Prison; and Dr. Ware, of 
Boston, made a publication in the American Journal of 31edical 
Sciences .for August, 1838, showing that eleven out of twelve 
patients were cured by him in the same way. 

The hive syrup of Dr. Coxe, so long employed as a popular 
remedy for croup and the colds of children, depends very much 
on tartar emetic for its remedial powers. It contains enough of 
that salt to nauseate, even in small doses, and so to prove expec- 
torant. This latter effect is always a consequent result of the 
nausea set up by the remedy, and should it vomit, as it may, 
expectoration is made more free and easy. The same effects 
often follow the use of tartar emetic, or antimonial wine, which 
are frequently resorted to as remedies for ordinary colds and 
coughs. On the same principle the external as well as internal 
use of tartar emetic has been serviceable in pertussis. 

Mr. Moore, assistant surgeon, Upper India, has treated a great 
many cases of intermittent fever with tartar emetic, and regards 
it as the best means of cure. He gave it in very small doses (a 
tenth of a grain) every hour during all the stages. In simple 
cases this alone sufficed; but if complications of congestion or 



164 TARTAR EMETIC A POISON. 

inflammation were present he resorted to general and local bleed- 
ing in addition to the tartar emetic. (See Braithwaite, part xx.) 
We may add that Professor Dudley, of Kentucky, has long been 
in the habit of treating intermittents by the frequent exhibition 
of emetics. 

The emetic treatment of chorea is probably less valued than it 
deserves to be. I do not speak of it as the practice above all other 
methods, but as one of the plans of cure that may sometimes be 
proper. A very interesting case of this disease in a child nine 
years old is reported as speedily cured by the use of antimonial 
wine. (See London Lancet , New York reprint, vol. i.) 

Why does tartar emetic frequently fail to vomit where that is 
the chief object in view, as in croup f Certain it is that very 
large quantities have been given, in repeated doses, and no 
vomiting has occurred ; or it has come on late in the attack, with 
a force almost irresistible. In the nineteenth volume of the 
American Journal of Medical Sciences a case is related in 
which a half-ounce was swallowed by a patient laboring under 
croup, and yet there was no vomiting. The neglect of proper 
depletion, either general or local, is the difficulty in such cases. 
The condition of the system is not right for the due emetic ope- 
ration. A few leeches to the throat, or a small bleeding from 
the arm, will secure a speedy emetic action from a quantity of 
tartar emetic that would otherwise be wholly inoperative. This 
doctrine was happily illustrated by Kush, and afterward by 
Eberle, and since their time it has been verified by thousands. 

But tartar emetic may be a real poison. The precise quantity 
that will act thus cannot be designated. Much will depend on 
the state of the stomach, as to fullness or vacuity, the general 
health and habits of the patient, &c. &c. In some instances the 
quantity swallowed has been so large as to paralyze the stomach 
and prevent vomiting. An ounce would have this effect, or even 
a much less quantity. In all such cases vomiting should be set 
up by local irritation, as by the finger or a feather thrust down 
the throat, or by forcing warm water into the stomach by means 
of a stomach-pump. 

When the quantity swallowed has been small and the irrita- 
bility of the stomach is very great, the best plan is to administer 
very strong green tea or coffee, or anything that contains tannin 
largely. Tannin itself is a good article. The tartar emetic is 
thus decomposed and rendered inert, while the further use of the 
remedy restores the stomach to its former condition. Should 
the case continue to be embarrassing, the treatment named when 
speaking of antimonial wine will be proper. 

It may be expected that something would be said respecting 
James's fever powder, the pulvis antimonialis of the books. 



ANTIPERIODIC. 165 

But as all secret medicines are repugnant to our feelings we feel 
indisposed to devote much time to this article, whose real compo- 
sition, as practiced by the inventor, is a matter of uncertainty. 
The powder most probably is a compound of phosphate of lime 
and protoxide of antimony. But we can always have at our 
command a better article, whose composition we certainly know, 
and therefore we should give it our preference. We allude to the 
nitrous powders previously spoken of. 

The chloride or butter of antimony is an old medicine, which 
is now rarely employed. Its leading property was that of an 
escharotic. 

Antiperiodic. — This term has come to be generally employ- 
ed because it seems to convey an idea not embodied in any other. 
But what do we mean by it ? Reference is had, in its use, to the 
periodical nature of various fevers and chronic diseases, which 
are cured in virtue of the power of certain medicines to break up 
the periodicity or periodical tendency so apparent in their pro- 
gress. Thus ague and fever is confessedly periodical, and neu- 
ralgic affections fire under the same or a like influence. We cure 
the one and the other by the exhibition of bark or the sulphate 
of quinine. We prevent the return of the periodic phenomena or 
paroxysms which constitute the grand features of the disease, 
and we regard the remedy as the proper antagonist of the mor- 
bid state and call it an antiperiodic. Now it is conceded that 
we know nothing more of periodicity, as related to disease, than 
that it consists chiefly of some change in the functions of the 
nervous system somewhere and somehow. The essential nature 
of the series of phenomena involved is not understood and pro- 
bably never will be. Yet we see the facts daily, and so palpably 
that we cannot doubt the agency of remedies to counteract and 
to nullify the basis of all periodical disease. Thousands on thou- 
sands are cured of all the grades of ague and fever by the anti- 
periodic agency employed, and the connection of cause and effect 
is thus demonstrated as clearly as in any other conceivable case. 

That the antiperiodic power of the sulphate of quinine is uni- 
formly developed under precisely the same circumstances none 
will affirm. It may act well in a system greatly enfeebled, and 
really prove a stimulant, primarily and constantly. It may act 
equally well in another system, and evince a sedative influence 
in some organ at least, if not in the whole arterial system. Yet 
in these apparently opposite conditions the final action may be, 
and undoubtedly is, what we call antiperiodic. 

Arsenic is an antiperiodic, and yet there are few, if any, who 
will contend that in all its agency in the human system, prior to 
'the final arrest of periodical disease, it affects the economy pre- 
cisely as it is affected by bark or quinine. Nevertheless we hold 



166 ANTIPHLOGISTIC — AQUA. 

it to possess decided power over periodicity, whatever the nature 
of that may be. Headland shows, conclusively, that the action 
of arsenical and quinine medicines is widely different ; that arsenic 
is a catalytic blood remedy, modifying the blood poison and the 
two passing out of the system ; while sulph. quinine is a restora- 
tive haematic, adding something to the blood that is lacking and 
itself remaining in the system. These remarks apply specially 
to the cure of periodical fevers. 

Antiphlogistic. — This term, like some others, is often em- 
ployed without anything like ,a correct knowledge of its import. 
We are advocates for a proper* acquaintance with the real design 
and value of all our technicalities. 

The word phlogiston was in use among the chemists of former 
times to denote the principle of inflammability or combustion 
supposed to be inherent in combustible bodies. The addition of 
anti and a slight change in phlogiston gives antiphlogistic, or 
against phlogiston, or inflammation, or the principle of inflam- 
mability. Hence the word, primarily and truly, has reference 
to all the means proper to subdue inflammation or high morbid 
action. It is therefore appropriately applied to all the forms of 
sanguineous depletion directed against the inflammatory process, 
and includes all other depleting remedies that have a like tend- 
ency, such as vomiting, purging, &c. &c. 

Antiplastic. — This term is synonymous with anti-fibrin, anti- 
inflammatory, &c. 

Apiol. — This is a new antiperiodic, of which mention has been 
made in the Brit, and For. Med.-Ohirurg. Rev., January, 1857. 
We have not noticed any other account of it. 

Aqua. Water. — The first remark to be made on this article 
relates to the writing of prescriptions. There is no advantage 
in appending fontis or any other word to aqua, but there may 
be positive evil when the appendix is carelessly written. This 
fontis has been so badly scrawled that the interpreter made fortis 
out of it, and hence he added aqua fortis in place of aqua fontis. 
The simple aqua, or its genitive, aquas, is all-sufficient, denoting 
water, and nothing more nor less. 

For medicinal uses, and to have neat compounds, water should 
be filtered or distilled prior to its use in putting up prescriptions. 
Distillation will give a purer result than can be had from filtering. 
It separates the water from all impurities and gives us the native 
fluid unadulterated. In the absence of the fixtures necessary for 
distillation any of the well-known methods of filtration will answer 
for ordinary purposes. 

The percolation of water through gravel and the crevices of 
rocks prepares it for the use of man as a common universal 
beverage. The fact that it has been accessible since the creation, 



MEDICINAL USES OF WATER. 167 

in any quantity and almost everywhere, seems to indicate the 
design of Heaven that it should be the natural drink of the race. 
Yet, happily as it is adapted to the wants of man, and simple 
and tasteless as it is, it has a fatal power when drank in con- 
siderable quantity by persons overheated by exercise in the sum- 
mer season. Hence in every large city cases of sudden death 
are reported every year as the result of this kind of imprudence. 
The accident is most frequent when the stomach is empty, and 
the cold drink has more opportunity to exert a morbid influence 
on the unprotected tissue of the stomach. The patient is almost 
instantly thrown into severe spasms, first of the stomach and 
then of the bowels, the pain of which is almost intolerable. The 
most prompt relief is obtained from the immediate administration 
of a teaspoonful of laudanum, and the application of sinapisms to 
the pit of the stomach and the extremities. In a paper on this 
subject, which I published in the New York Med. Repository 
many years ago, it was attempted to be shown that these acci- 
dents were seldom heard of in country locations, nor in persons 
known to be habitually temperate in the use of strong drinks. 
It is quite possible, however, for the same results to follow the 
imprudent drinking of iced water or very cold water by persons 
overheated, anywhere, no matter how temperate their habits. 

Although there is really no positive nutriment in water, it is 
matter of fact that individuals have subsisted many days on water 
alone. But it should be remembered that the fatty matter in 
the omentum and other parts of the economy is taken up by 
the absorbents, in all cases of starvation, and converted into 
blood ; so that the system has really, for the time, an internal 
sustaining power, which seems to be kept up by water. 

Not only was water at one time the only beverage of the race, 
but there was a period when it constituted the chief means of 
curing disease. The Italians treated fevers, centuries ago, al- 
most exclusively with ice and cold water, internally and exter- 
nally administered. In smallpox the cold water treatment was 
successfully employed long before the sect of hydropathists had 
existence. In the Memoirs of a Babylonish Princess we find 
an account of a time-honored practice from which it is very 
likely that modern hydropathy took its rise. " During the hotest 
months," says the writer, "when the thermometer is at 120° of 
Fahrenheit, the ladies wear a silken garment or chemise, and 
slippers, but no stockings. At night it is the custom to sleep on 
the terrace at the top of the house, in the open air, the ladies, the 
men, the children, and the domestics having each their separate 
terraces. Strange as it may sound to European ears, it is by no 
means an uncommon practice with the ladies of Bagdad, in the 
months of July and August, to steep their night-clothes in cold 



168 MEDICINAL USES OF WATER. 

water, which is slung up for this purpose in skins in order to 
keep it as cool as possible. Having done this they put them on, 
wringing wet, and again retire to their beds of palm branches to 
enjoy refreshing slumbers. Notwithstanding this practice, rheu- 
matism, so prevalent in England, is rarely heard of in that country. 

The facts developed in this piece of history are of high prac- 
tical importance, and may well rebuke the timidity of medical 
men everywhere touching the internal and external use of cold 
water. The thne has been in this country when a patient burning 
with a fever and dry tongue was forbidden a drink of cold water, 
and ice would have been regarded in the light of a poison. In 
this delusion we never shared, having never witnessed any sort of 
injury as the effect of cold or even iced drinks, taken moderately 
by fever patients. Nay, what is even more heterodox in the esti- 
mation of many, we never refused a drink of cold water to a 
patient because he had taken calomel, or was at the moment in a 
state of gentle ptyalism. Our experience has yet to assure us 
that a thousandth part of the mischief said to flow from the prac- 
tice had any legitimate connection with it. The worst-swelled 
faces we have ever seen were in subjects who, while profusely 
salivated, were not allowed a drop of cold water, though imperi- 
ously demanded by nature. 

According to my observation, no one remedy is so grateful 
to patients laboring under bilious remittents as ice, used ad libi- 
tum ; and none more safe. In the exquisitely irritable stomach 
of gastritis, when every other article is forcibly ejected as an 
intruder, ice is not only tolerated but is often indispensable. 

To aid my medical brethren in a just appreciation of this very 
ancient remedy, a few extracts will now be presented from the 
well-known works of Dr. Lettsom, which were published long be- 
fore hydropathy presented itself, as a system, to the world. The 
facts are furnished by Dr. Pearce in Letters addressed to Lett- 
som, between the years 1760 and 1781, and written in St. Croix. 
"In ardent fevers I have used the cold bath and lemon juice 
with great success ; and repeated trials have satisfied me that two 
or three wineglasses of lemon juice given in the height of a fever 
in the course of the day, with cold water in the intervals, sur- 
passed every other medicine as a febrifuge : it composed the 
stomach, promoted expectoration, and checked cough." (Vol. iii. 
p. 407.) "Cold immersions and full draughts of cold water were 
the most efficacious remedies in the treatment of the dry belly- 
ache" (Ibid. p. 407.) "A negro wench was attacked with con- 
tinued fever, became delirious on the ninth day and remained so 
till the twenty-second. She was then stripped and six pails of 
cold water poured over her head and body. She became in- 
stantly sensible, was put into bed, and a wineglassful of lemon 



USES OF WATER AS A REMEDY. 169 

juice administered. She fell asleep and rested comfortably for 
more than six hours, when she awoke free of pain or distress of 
any kind, excepting a sense of debility. A suitable diet restored 
her to health." (Ibid. p. 409.) "The practice in bilious fevers 
was to pour over the naked body three gallons of cold water, 
after which the surface was wiped dry and the patient put to bed, 
having taken a wineglassful of lemon juice. This process was 
repeated, if necessary, every two hours, until the fever ceased, a 
result that followed usually in from six to eight hours. Often 
a single effusion sufficed." (Ibid. p. 411.) "In sore throat, how- 
ever severe, nothing more was needed than two or three table- 
spoonfuls of lemon juice several times a day, and a stocking or 
other fixture well soaked in cold water applied round the neck. 
The patient was soon relieved. The worst quinsies and sore 
throats were promptly cured in this way." (Ibid. p. 412.) "A 
negro sailor was seized with severe pain in the bowels and high 
fever ; he was bled, and took camphor, nitre, &c, employed warm 
fomentations, all in vain ; woollen clothes well soaked in cold 
water were then applied to the abdomen, acid drinks and cold 
water frequently given. The pains and fever soon ceased and 
the man was soon well." (Ibid. p. 414.) " Suppression and re- 
tention of urine were quickly relieved by cloths dipped in cold 
water applied to the abdomen, and a wineglassful of lemon juice 
at the same time." (Ibid. pp. 414-15.) Many other extracts 
could be given, but these must suffice. In a note to page 408, 
Dr. Lettsom observes that "Dr. Pearce employed cold drinks 
and cold bathing in the low bilious remittent and typhoid fevers 
of the West Indies with so much success as thereby to get into 
good practice." 

But if the more modern work of Ranking be consulted it will 
be seen that the cold water treatment has been equally successful 
in England in more recent times. In Nos. 5, 6, and 7, of the 
Abstract, cases in point may be found, furnished by distinguished 
and competent men. Braithwaite s Retrospect, No. 15, contains 
the same kind of testimony. 

An Episcopal bishop, (Dr. Gobat,) who has resided for years in 
Jerusalem, gives an interesting fact of his own personal experi- 
ence, in the use of water internally and rain-water externally 
to cure a severe ague followed by burning fever. The attack 
came on at twilight, and three large glasses of water having been 
swallowed he soon fell into a gentle slumber. He was soon 
roused by a heavy fall of rain, which effectually drenched every 
article of clothing he had on ; even the carpet beneath him was 
soaked, as the rain fell in torrents. He wrapped himself in his 
clothes, dripping as they were, and laid him down to rest. His 
linen absorbed the heat which radiated from his feverish limbs, 

12 



170 ICED WATER MEDICINAL. 

and at dawn of day lie was able to take his departure, feeling 
as well as usual. — Journal of 1850, p. 151. 

Not wholly unlike the foregoing is Dr. Heaton's case, reported 
by himself in the Boston Med. and Surg. Journal, March 10, 
1852. He had labored under an ague a good while, and deter- 
mined to try the effect of jumping into the Mississippi river when 
the cold stage was on him. He had no return of the ague after 
this experiment. 

Iced water, drank without measure or restraint, saved indi- 
viduals from the grave who were abandoned as hopeless cases in 
the Asiatic cholera of 1832 and '33. In my lecture on that 
disease, published by my medical class in May, 1849, mention 
is made of a very striking case of this kind the subject of which 
yet lives and is personally known to the author. The indication 
for the use of the water was instinctive, or rather providential. 
It induced copious perspiration, of a salutary nature ; the lady 
fell into a sweet sleep, awoke refreshed, and gradually recovered. 
Hers was a case of the most manifest collapse that had occurred 
in the place. The explanation I have offered to solve this use 
of water was that the absorbents immediately took up the fluid 
to carry into the blood a supply to compensate for the loss of its 
serosity, as the result of the morbid action in the system. 

Dr. Lewis (a very respectable graduate of the Lexington 
school) has given to the Stethoscope, published in Richmond, Va., 
a good paper, in which he shows pretty clearly that cistern-water 
has proved a prophylatic in respect of Asiatic cholera. (See 
January No. for 1853.) We may here say that the same view 
has long been held by Professor B. W. Dudley, and other dis- 
tinguished physicians of Kentucky. 

A very important use of water is that reported by Dr. Samuel 
Jackson, formerly of Northumberland, Pa., in the American 
Journal of Medical Sciences. He found that the usual remedies 
for scarlatina maligna utterly failed, and the disease being in 
his own family, he resolved to test the power of water in the 
shape of ice. He found that lumps of that substance placed in 
the mouth and gradually dissolved there not only allayed the 
irritation of the throat, but acted happily on the system, redu- 
cing the pulse from one hundred and forty to eighty or ninety. 
His success led other physicians in the vicinity to adopt the same 
treatment, and with most happy results. 

When measles were epidemic at Berlin, in the year 1823, Dr. 
Thaer conceived the idea of using cold lotions, composed of vine- 
gar and water, on all parts of the body. He treated sixty-eight 
out of one hundred and twenty cases in this way, and lost but 
one, while eleven of the remaining fifty-two perished. The dis- 
ease assumed a very inflammatory character, and the manner in 



USE OF COLD LOTIONS IN MEASLES. 171 

which the sick were surrounded by warm clothing and heated air 
much increased this state. 

In some of the cases treated by Dr. T. the lungs and brain 
were affected; and in all such cases, before he commenced the 
cold applications, he had leeches freely applied and cooling reme- 
dies exhibited. Moreover, he never neglected reducing the tem- 
perature of the sick chambers. By this plan of treatment the 
most desperate cases terminated favorably, and but four died. 
The fatal cases were far advanced when medical aid was first 
afforded, and they had been much aggravated by warm apart- 
ments and bedding. 

When the lotions were once commenced, all other means were 
discontinued. He began to use the applications when the tem- 
perature of the body exceeded 27 J° R. (equal to about 62° of 
Fahrenheit ;) for it was then he observed that the patients be- 
came much agitated and then- respiration hurried. He varied 
the temperature of the lotions according to the heat of the body, 
— the higher the animal heat the lower did he make that of the 
lotions. He never employed them higher than 26° or lower 
than 1J° R. ; the heat of the body in the former case being 
29J° and in the latter 35° R. Finally, he never continued them 
for more than eight or less than four minutes at one application. 
He says that the lotions should not be used if the infant is tran- 
quil, or when it is perspiring. 

We are assured that children treated in this way get well in 
eight days ; the desquamation is prompt and abundant, and the 
convalescents may expose themselves to the free air during the 
desquamation and before the catarrhal cough has altogether 
ceased. When the affection of the lungs is far advanced the 
use of the lotion is followed by abundant expectoration. 

He thinks that if such patients could be kept in an atmo- 
sphere of 13° R. we might dispense with the cold lotions. 

He follows this practice with great advantage in scarlatina 
and pertussis. (Hecker, Litter ar. Annalen der gesammten Heil- 
kunde.) 

The external uses of cold water, warm water, and ice, are very 
important. To say nothing specially of the shower bath, the 
warm bath, and bathing with water of various temperatures, there 
are many applications of the remedy that are highly valuable. 

The following hygienic use of cold water by the ladies of Bag- 
dad may furnish a hint of practical value as to its prophylactic 
powers: — During the hottest months, when the thermometer is 
often at the height of 120° Fahrenheit, the ladies wear a silken 
garment or chemise, and "babouches" or slippers, but no stock- 
ings. At night it is the custom to sleep on the terrace at the 
top of the house, in the open air, — the ladies, the men, the chil- 



172 COLD DASH IN CONGESTIVE FEVER. 

dren, and the domestics, having each their separate terraces. 
Strange as it may sound to European ears, it is by no means an 
uncommon practice with the ladies of Bagdad, in the months 
of July and August, to steep their night-clothes in cold water, 
which is slung up for this purpose in skins in order to keep it 
as cool as possible. Having done this they put them on, wring- 
ing wet, and again retire to their beds of palm branches to enjoy 
refreshing slumbers. Notwithstanding this practice, rheumatism, 
so prevalent in England, is rarely heard of in that country. — 
Memoirs of a Babylonish Princess. 

In Braithwaite s Retrospect, part xvii. p. 50, is the report of 
cases of delirium tremens successfully treated with cold water 
dashed over the head and the entire body repeatedly until the 
patient became composed. After free use of the cold water he 
was well wrapped in blankets. 

Cold water or ice applied to the head and continued for an 
hour or longer is reported to have been successful in apoplexy. 
There can be no doubt that when the circumstances forbid the 
use of the lancet this expedient may be very effectual. It cer- 
tainly merits attention, as being in many cases better suited to 
the nature of the disease than free depletion. 

M. Chassaignac, of Paris, has lately advised, in the Gf-azette 
des Hopitaux, the use of ice in various severe forms of ophthal- 
mia. He does not employ ice exclusively, but as an adjunct to 
other treatment. He applies it by means of a kind of orbital 
mask of wirework, secured by a spring, the pad of which presses on 
the occiput. The mask is composed of two layers, between which 
little bags of ice are introduced. (See London Lancet, Feb. 1850.) 

The cold dash has long been very popular in the management 
of the congestive fever of the far South, and most probably acts 
very much as in the various cases of narcotic poisoning, in which 
it has been so successfully employed. It rouses the dormant 
energies and brings on reaction, if sufficient vitality remain to 
permit that result. In my opinion the nervous system is im- 
plicated very much in the same manner in both cases. 

Cold water freely dashed over the naked abdomen is among 
the most efficient modes of overcoming obstinate constipation. 
This disease is often kept up by a fixed spasmodic contraction, 
which very often resists all internal medicines, and yields finally 
to the persevering use of the cold dash. Tetanus, hysteria, &c. 
have occasionally been cured in the same way. 

In a German medical journal for April, 1845, Dr. Garray, of 
Venice, urges the importance of cold water as an external remedy 
for phthisis pulmonalis. He observes "that, having lately seen 
Dr. Marshall Hall's remarks on the application of alcoholic 
washes in phthisis, he was led to adopt cold water in preference. 



USES OF ICE AND COLD WATEK. 173 

He points out that the inflammatory condition of the lungs in 
this disease, the deposition of tubercle, and the cough, bear a 
relation to each other ; that one produces and keeps up the other, 
and that if one can be diminished the whole are benefited. The 
cough, for instance, keeps up the inflamniatory condition of the 
lung, and this, in its turn, both favors the cough and tubercular 
deposition. Cold water, he argues, applied locally, is one of the 
most powerful means of arresting local inflammation and its 
termination, by softening or suppuration ; and he asks : If this 
could be accomplished in phthisis, why might not the other 
symptoms disappear? He was induced, by this reasoning, to 
order repeated applications of cold water to the chest of phthisi- 
cal cases, and, as he says, with favorable results. He relates 
one case, accompanied by considerable inflammation of the lungs, 
and fever, where, by means of cold water poured over the neck 
and chest morning and evening, for three months, all the symp- 
toms disappeared." 

I have applied cold water cloths around my throat for the 
relief of inflammation of the fauces, to which I was very liable, 
with most marked benefit. I made the application at bedtime, 
covering with a large silk handkerchief, and the next morning 
found the throat well, the surface being deeply reddened. 

M. Cazenave reports, in the London Journal of Medicine for 
August, 1849, a case of retention of urine relieved, by ice and 
cold water. The latter was injected freely, after having emptied 
the bowels by means of a cathartic enema. The ice was applied 
in bladders around the penis, on the perineum, thighs, anus, and 
hypogastrium. A water-proof cloth being placed under the 
patient, a continuous stream of cold water was made to fall on 
his loins for twenty-five minutes. In an hour the difficulty was 
overcome. The practice was resorted to in cases in which the 
catheter could not be introduced because of chronic inflammation 
of the prostate. (See Ranking, No. 10, p. 136.) 

In Braithwaite s Retrospect, part v., is an account of infantile 
convulsions manifestly arrested by the application of ice to the 
spine. A more common practice has been to apply sinapisms 
and other irritants to the spine, and frequently they have appa- 
rently done good. We learn, however, from the statement in 
Braithwaite, that an opposite practice is sometimes called for. 

Of ice to the head in the treatment of bilious remitting and 
other fevers it is not needful to say much. The practice is 
happily in pretty general use. The best mode is to apply it in 
a bladder, the neck of which being tied the application can be 
made without wetting the bed-clothes. The ice should be broken 
into pieces as large as a walnut. 

Pounded ice freely swallowed promotes uterine action, and 



174 USES OF COLD WATER. 

should be taken when abortion is inevitable and the uterus is 
contracting feebly and the hemorrhage is considerable. (See 
Braithwaite, p. xix.) 

Dr. Hildreth, of Wheeling, Va., has given some interesting 
cases in the Cincinnati Medical Observer for February, 1857, to 
show the safety and efficiency of ice passed into the uterine cavity 
to arrest hemorrhage there. We tested this practice too often, 
thirty-five years ago, to have a doubt in the premises. We not 
only put ice into the uterus, but surrounded the pelvis with ice. 
In no instance did we realize any unpleasant result. 

The cold water treatment of sprains and contusions is also 
important. Dr. Poulin, a French military surgeon, condemns 
depletion altogether, (as by leeches,) and advocates cold water. 
This is to be applied immediately, and, if practicable, the part 
is to be immersed in cold water and to be kept there for two 
hours at least. Even days may be consumed in this use of the 
water, if relief be not complete before. It is ordered that the 
water must be changed as soon as it begins to get warm. After 
the proper use of the cold water a bandage is to be applied wet with 
spirits of camphor or Goulard water. — Med.-Ohir. Rev. July, 1846. 

Cold water has long been a popular remedy for burns and 
scalds, and I know it is perfectly safe. I have been burned 
with phosphorus and hot acids in the laboratory, and can testify 
to the relief afforded by ice and iced water, and with no untoward 
circumstance accruing. On one occasion a retort was fractured 
containing the materials for making chlorine gas, and the con- 
tents were dashed into my eyes so as almost entirely to deprive 
me of the use of the organ. Cloths wet with ice-cold lead-water 
Were at once and constantly applied; the inflammation was 
arrested, and on the next day I was able to lecture. Additional 
information on this use of cold water may be found in the Ameri- 
can Journal of Med. Sciences for October, 1847. 

The treatment of burns by iced water is very successful in the 
Hopital St. Louis. M. Jobert speaks of it very confidently, 
even for extensive burns. Large pledgets of cloth steeped in 
cold water are laid on, and these are covered with bladders of 
ice. In bad cases, the lancet, low diet, and refreshing drinks are 
employed. Under the treatment the patients are refreshed, the 
pains abate, fever lessens, and the whole system is invigorated. 

Injections of cold water once or twice a day will often prove 
an excellent means for overcoming habitual costiveness ; and it 
is proper to say that warm water injections sometimes effect the 
same end. In the one case there is a lack of tone in the bowels, 
and in the other too much excitement. 

Injections of cold water have been found very effectual for the 
relief of excessive tympanitic distension. The cold contracts 



USES OF WARM WATER. 175 

the bowels and diminishes the gaseous expansion, while the water 
absorbs a portion of the gas. The injection may be frequently 
repeated. — Professor Schonlein. 

Warm water is often an excellent application to parts affected 
with erysipelatous inflammation. I am aware that cold appli- 
ances are more frequently made in this form of disease, yet I 
know from experience and observation that the burning heat and 
itching of erysipelas are promptly relieved by warm water con- 
stantly applied to the surface. At the same time it is necessary 
to correct the digestive organs, which are almost uniformly at fault. 

Warm water injections frequently thrown up the rectum while 
the patient is in the warm bath will often give great relief in 
colica pictonum and constipation of the bowels from ordinary 
causes. Itching about the anus, on the genitals, &c, is gene- 
rally abated sensibly by the frequent application of water as hot 
as it can be borne. 

In March, 1853, I was attacked with great severity with neu- 
ralgia of the right hip and thigh. The pain was of the most 
excruciating character, and continued for several hours to resist 
the internal and external use of opiates, chloroform-liniment, 
ointment of veratria, &c. &c, and finally yielded to the per- 
sistent application of water almost at the boiling-point. Flannel 
cloths dipped in the fluid were reapplied with great pertinacity 
for about two hours, and sleep of a soothing character ensued. 
When the pain returned, some hours after, it was checked by 
resorting to the hot water as before. 

Mr. Hare, surgeon of the Bengal cavalry ', recommends very 
highly the use of warm water injections in the acute dysentery of 
that country. Generally, it is necessary to bleed first pretty 
freely. The chief dependence afterward is on the injection of 
warm water by means of a long elastic tube passed up beyond 
the sigmoid flexure. From four to six pints are thrown up daily. 
The inflamed parts are thus soothed, the hardened feces softened 
and brought away. In the chronic form of the disease he cleans 
out the bowels with warm water injections, and then throws up 
injections of nitrate of silver, made by adding fifteen grains to 
a quart of water ; or he relies on the repeated warm water in- 
jections, and gives small portions of the nitrate of silver by the 
mouth, applying leeches occasionally to the abdomen. He rarely 
uses mercury, excepting in the form of ointment. (See Braith- 
waite, part xx.) 

In the Q-azette MSdicale, 1844, Dr. Roche advocated the in- 
jection of warm water into the uterus to prevent puerperal fever. 
Very lately Dr. Gensoul, of Lyons, has revived this plan in 
Ju Union Medicate, affirming that phlebitis of the womb is often 
brought on by the detritus and clots stagnating in the uterus, 



176 COMMON BURDOCK. 

and that warm water injections, by removing these, will contri- 
bute largely to keep off the fatal effects of uterine inflammation. 
(See London Lancet, February, 1850.) 

In the London Medical Times for August 25, 1848, is a 
paper in which it is affirmed that scarlatina has been arrested by 
the application of hot water compresses to the epigastrium, and by 
enveloping the patient in blankets to induce copious perspiration. 

It is not easy to reconcile this with the usual treatment of this 
disease. We present the fact for consideration. 

The therapeutic action of warm water has been very happily 
extended to the treatment of croup by Dr. William Budd, 
physician to the Bristol Infirmary, as we learn from the Medical 
Times and Gazette of June, 1852. 

The mode of procedure was quite simple, and that commends 
it strongly. The child was placed in a bed enclosed by a double 
curtain. Near to the child was placed an earthen pan nearly 
full of water almost boiling, and a hot brick was plunged in now 
and then to evolve steam. The air within the curtain was thus 
filled with vapor at from 75° to 80° Fahr. Besides this, an 
emetic was occasionally given, just to assist in expelling the 
morbid product in the trachea, which is all important. From 
the moment of inhaling the hot vapor the case was obviously 
improved, and in two hours the child was much better. 

Cases are given in detail showing the value of this very simple 
method of cure. 

The vesicant power of hot water is sometimes of practical 
value, as when it is desired to blister a part in an instant. Pro- 
vide a bowl and a towel large enough to fill it completely. Pour 
boiling water on the towel until it will hold no more; invert the 
bowl and apply to the spot where it is desired to detach the skin, 
and a blister will be the result at once. 

Touching water impregnated with mineral and saline matters, 
and therefore called mineral waters, a great deal might be said. 
It is certain that these waters are often feeble, and that more 
potent drinks can be manufactured containing all the constitu- 
ents of the native waters. The effect, no doubt, depends on 
change of scenery, of society, of living, of associations, and on 
relief to the mind from the troubles and cares of city business. 

For much valuable information on the subject of water in con- 
nection with bathing, see Bell's Booh on Baths. 

Arctium Lappa. Common Burdock. — This is a very com- 
mon plant; too common, I suppose, in the estimation of many. 
The books, without an exception, say that the root possesses 
some little diuretic and alterative power, but that it is pretty 
much laid aside, as a comparatively worthless article. It is 
brought forward here to show its efficacy in obstinate eruptions, 



BURDOCK AN ALTERATIVE — SILVER. 177 

that frequently for a long time baffle medical skill. Professor 
Graves, of Dublin, reports a very interesting case in bis Clinical 
Lectures, which has attracted my attention and led me to re- 
commend the medicine in like cases. He had under his care a 
young man who had long been afflicted with an impetiginous 
affection, attended with varicose veins, a purulent and ichorous 
discharge, making a distressing case. It had been treated with 
leeches, poultices, astringent washes, and all the ordinary appli- 
ances. The discharge increased, while the heat and itching were 
almost intolerable. An old lady advised a trial of burdock root ; 
four ounces in a quart of water to be boiled to a pint, and the 
whole to be drank in a day. In three or four days he was much 
better; but, as Dr. Graves was in doubt as to the efficacy of the 
burdock, he ordered its discontinuance. The man soon became 
worse, and continued to suffer as before. The burdock was re- 
sumed, continued for a season, and the patient was completely cured. 

Dr. W. Barton, of South Carolina, who had heard the above 
statement in my lectures some years ago, called on me, in the 
winter of 1848-9, to say that he had put the burdock to the test 
in an old case of skin disease, and with entire success. 

I have known a most obstinate case of scrofulous ophthalmia, 
that had been under various treatment to no good purpose, yield 
in a few weeks to the burdock. The juice of the mature leaf 
was employed in teaspoonful doses three times a day, the patient 
being about five years old. 

There can be no doubt, I think, that burdock is possessed of 
decidedly alterative properties, which make it a valuable remedy. 
It acts on the skin and kidneys. The ground root, neatly 
packed in pound papers by the Shakers of Lebanon, New York, and 
for sale in most of the cities and towns, will probably be found a 
better article than that which is generally sold in the form of root. 

Argentum. Silver. — This metal is too well known to need a 
description. As a metal it is not now employed by physicians in 
any part of the world. Many years ago a German, by name 
Meyer, professed to cure ague by giving fifteen grains at' a dose 
just before the paroxysm was looked for. If the first dose failed, 
a second, it is said, was always successful. Professor Serres, of 
Montpelier, also exhibited the filings of pure silver in syphilis. 
A case of the supposed efficacy of metallic silver is also given 
in the third volume of the Transactions of the London College of 
Physicians, by a Dr. Coyte. The patient was certainly cured of 
epilepsy, but not, as I think, by metallic silver, but by a salt of 
that metal formed in the stomach; for the metal in all proba- 
bility has no medicinal power as such. The history of the case 
is this : — A man, aged forty-six, had epileptic fits from his in- 
fancy, and to save his tongue from severe injury, carried a silver 



178 LUNAB CAUSTIC. 

crown piece in his pocket, to be placed between his teeth so 
soon as a fit was about to come on. On March 12, 1771, 
he accidentally swallowed the piece of silver. In September, 
1772, he was seized with fever, for which emetics were ordered ; 
active vomiting caused the ejection of the coin, nearly twenty 
months after it had been swallowed; and down to July 6, 1773, 
the date of the published article, he had no return of fits. The 
coin was blackened and corroded on the edge, and there can be no 
doubt that a muriate or acetate, or both, were formed. The facts as 
stated are sufficiently authentic, and the case is certainly instructive. 

The nitrate of silver has long been employed in the practice 
of medicine. Its more common name, lunar caustic, indicates 
one of its properties. It is a compound of nitric acid and oxide 
of silver. As we usually see the article it is of a grayish color, 
a dark-white, and sometimes exhibiting a tinge approaching to 
blue or black. This is the effect of light, which exerts a chemi- 
cal agency and causes discoloration, for the crystals can be made 
so pure as to be transparent and nearly destitute of color. To 
get the caustic as we employ it, the salt is fused so that it can 
be poured into moulds gently tapering, where it contracts when 
cool, so that the sticks are easily forced out of the moulds. It 
is then nearly white, and is covered well with blue paper to 
guard it from the light. 

This salt is liable to adulteration with other metals, especially 
copper. The purest quality is made of silver and nitric acid 
only, and the highest priced article is apt to be the best, for an 
obvious reason. Physicians will find it of variable price, and 
they should understand that the secret lies in the relative quan- 
tity of silver employed in the manufacture. A really good article 
cannot be procured honestly for the price of an inferior one. 

The nitrate of silver is preferred, as an escharotic, to common 
caustic, because it scarcely can be said to deliquesce. It may 
stain the fingers by frequent use, and hence it has been coated 
with sealing wax by Dumeril, to guard against this inconvenience. 
The stick and the watery solution are both employed as agents 
to operate on the surface. The solution may be made of any 
desired strength. From five grains in an ounce of water to a 
drachm dissolved in the same amount of liquid the range is suffi- 
ciently wide for all contingencies. 

When the stick or solution is applied to an ulcer, a gray film 
is soon perceived to cover the surface. This is the effect of 
chemical action on the albumen. Frequently repeated, with the 
same result, a decided impression is made on the ulcer a new 
and more salutary action being thus set up. 

The solution is usually applied by means of a camel* s-hair 
pencil, two or three times a day, according to circumstances. 



USES OF LUNAR CAUSTIC. 179 

An advantage in the application is obvious in the very small 
amount of discomfort it gives to the patient. It is often useful 
to small aphthous sores of the mouth and to scorbutic gums. 
Injected into fistulous ulcers it promotes healthful action and 
union of the parts. 

A most agreeable and salutary counter-irritant is found in a 
solution made by dissolving from a quarter to a half-grain of 
nitrate of silver in an ounce of rose-water. It is applied to the 
eye affected with subacute ophthalmia, presenting a good deal 
of uneasiness, and a sensation as though particles of sand were 
present. The best mode of applying this and all other eye- 
washes is in the eye-glass sold by the apothecaries. Every part 
of the external eye is thus brought in close contact with the 
solution. I have employed the eye-glass with this solution, in 
my own person, and derived great relief from its use. 

The counter-irritant action is also seen in the use of the solution 
as a remedy for chilblains or frost-bites. The stick caustic is 
preferred by some, but if the solution be made strong it will 
answer very well. An ounce of water should contain from half 
a drachm to a drachm of the salt. The application should be 
made at bedtime, after having washed the parts with warm soap- 
suds. 

On the same principle, too, in part at least, does the solution 
act when applied to sivollen tonsils and inflamed fauces. The 
tonsils, especially in scrofulous subjects, will . suddenly become 
very much swollen, so as to fill the throat and set up very 
troublesome cough. A very speedy method for the relief of 
this, as well as of inflamed fauces, is to apply a solution, made 
by dissolving a drachm of the salt in an ounce of water, far 
back in the throat by means of a soft sponge tied fast to a 
whalebone stick, constituting an ordinary swab. 

The progress of croup of the inflammatory form has been 
promptly arrested by the use of the strong solution applied as 
above; some insist on a much stronger solution. It seems to 
arrest at once the existing inflammation and to prevent its dif- 
fusion. Many cases have been detailed, in our own and foreign 
journals, to show the efficacy of the nitrate in membranous croup. 
We may refer the reader to the American Journal of Med. 
Sciences for July, 1851, for a very interesting case of this kind. 
The very troublesome affection which so seriously annoys clergy- 
men and other public speakers, and which depends on follicular 
ulceration and inflammation of the larynx, has been successfully 
treated with the nitrate of silver by Dr. Horace Green and 
others. The stick, or a very strong solution, is brought to bear 
on the parts affected, by careful manipulation which demands 
some experience. Much useful information on this subject will 



180 USES OF LUNAR CAUSTIC. 

be found in Braithwaites Retrospect, part xix. pages 119-127. 
Dr. Green insists on the decided superiority of the crystallized 
nitrate of silver over the common lunar caustic as a local remedy. 
From two to four scruples are dissolved in one ounce of water, 
and applied by means of a bent whalebone directly to the mucous 
lining of the larynx and trachea. The nitrate combines with 
the albumen of the parts and induces a favorable alteration in 
the vital action of the tissues. (See his book, page 29.) 

Dr. Ravenhill Pierce gives the following testimony in respect 
of the treatment of hooping-cough by nitrate of silver, in the 
London Lancet for July, 1857 : — 

"In seventy-five cases, (thirty-two boys and forty-three girls,) 
varying in age from two to eight years, which came under my 
care during last autumn, in a school containing over a thousand 
children, I used the local treatment recommended by Dr. Eben 
Watson, viz., sponging the glottis once a day with a strong solu- 
tion of nitrate of silver (one scruple to one ounce of distilled 
water) by means of a curved probang; and in combination with 
this I ordered Dr. Gibb's nitric acid mixture, (dilute nitric acid, 
twelve drachms ; compound tincture of cardamoms, three drachms ; 
water, one ounce; simple syrup, three ounces and a half,) a tea- 
spoonful every three hours. I also from the commencement 
gave a teaspoonful of cod-liver oil twice a day, and at the same 
time kept the patients on generous diet and in warm yet well- 
ventilated rooms. 

"Now this treatment has in my hands been invariably success- 
ful; and the little sufferers have not only escaped all those 
troublesome and dangerous complications which so frequently 
attend and follow hooping-cough, but have at the termination of 
their illness, in numerous cases, gained both flesh and stamina. 
I am perfectly aware that both the nitrate of silver and nitric 
acid plans have been used separately, but I have not heard of 
the two methods being combined. 

"I am desirous of calling particular notice to the fact of my 
having given cod-liver oil from the very commencement of the 
attack, instead of waiting till the period of convalescence; and 
to this as well as to the generous diet I, in a great measure, at- 
tribute the satisfactory and non-debilitated state of the patients 
at the time of their recovery. 

"I would also mention that after a few applications of the solu- 
tion of nitrate of silver I have found that the force of the pecu- 
liar spasmodic cough has been diminished in frequency and 
intensity, and the shock to the system caused by the straining 
and convulsive efforts of the patient consequently much lessened." 

The use of nitrate of silver as a remedy for erysipelas has 
long been known to the profession. Higginbotham, of England, 



USES OF LUNAR CAUSTIC. 181 

has written the best work on this subject, and done more than 
any one else to set forth the value of the practice. In this 
country the remedy is extensively applied; but there are some 
who err in regard to the strength of the solution, and this is the 
reason why it has not been more generally appreciated. It 
should not be weaker than a drachm to the ounce of water. It 
is necessary to carry the solution beyond the inflamed parts a 
small space, and often one application thus made will suffice. 
It seems at once to fix the boundary of the inflammatory action 
and to change the morbid process into a more healthy state. 

Mr. Higginbotham has recently furnished some interesting 
facts to show the advantage of nitrate of silver in lacerated 
wounds. Cases are cited of wounds of the face and lacerations 
of the perineum to enforce his position. He contends that the 
irritability of the parts, after properly uniting the edges, is 
promptly controlled by touching the parts with the caustic. 
(See London Lancet, April, 1850.) 

The strong solution and weaker ones have been applied to 
burnt and scalded parts, and some have used the stick caustic 
in similar cases. Pain is speedily allayed, and a new cuticle 
is soon formed. Having covered the whole surface with the 
caustic, a thin dressing is laid on of soft lint coated with mild 
cerate. 

The solid caustic is one of our best remedies for excoriated 
and fissured nipples. This is a troublesome and painful affec- 
tion. The caustic should be cut to a very fine point, so as to 
allow it to be passed down to the bottom of every fissured part. 
The nipple is then to be dressed with soft cerate, and to be pro- 
tected from the child's mouth by a shield, or by feeding the child 
in some other way. The application of the caustic is sometimes 
so painful as to make it necessary to administer an opiate. But 
the local relief is more likely to be permanent than from the use 
of any other appliance. 

The bed sores which assail the back and other parts of patients 
long confined are often promptly relieved by the use of nitrate of 
silver, first washing the sores well with weak chloride of soda, or 
soapsuds. It seems to set up a new and most salutary action, 
and the healing process is accelerated. The stick or the strong 
solution is to be employed. 

The ectrotic or abortive treatment of gonorrhoea and leucor- 
rhoea by means of lunar caustic has been for some time before 
the profession, and many approve it. The solid stick is pre- 
ferred by most physicians, and is introduced into the urethra, 
or brought in contact with the vagina, and allowed to remain 
there long enough to excite some irritation. Some have used a 
strong injection of the caustic. The remedy acts by counter- 



182 USES OF LUNAR CAUSTIC. 

irritation, setting up a new action and controlling the previous 
state. 

Painting the interior of the nares with a solution of nitrate of 
silver was proposed by M. Tessier, in 1845, as a mode of arrest- 
ing or cutting short a catarrh. Dr. Lockwood, of U. S. Navy, 
has since suggested the same treatment. 

Chronic cystitis, attended by frequent mucus discharges, has 
been greatly relieved and often cured by injections of the nitrate of 
silver thrown into the bladder and retained at least five minutes. 
From eight to sixteen grains are dissolved in from two to four 
ounces of water for this purpose. (See American Med. Journal, 
Oct. 1847.) 

Dr. McDonnell has also given his experience in the British 
American Journal of Medical Science for June, 1849, touching 
the efficacy of injections of nitrate of silver for the cure of 
chronic inflammation of the bladder. He injects water at 98° 
into the bladder to clean it out, and then throws in four ounces 
of the solution of nitrate of silver, which are allowed to remain 
not longer than a minute. The patient is then put into a warm 
bath, and anodynes given, if necessary, to allay pain. The in- 
jection contains from five to ten grains to the ounce of water. 
It is best to begin with a weak solution. 

In some of the cases reported there was obvious chronic en- 
largement of the prostate gland. 

Injections, consisting of twenty grains to an ounce of water, 
have been employed successfully in cases of high irritability of 
the bladder, by W. Reeves, Esq., of Carlisle, who reports in the 
Lond. Lancet for June 11, 1853. There is some soreness and 
pain after the injection is passed, but these are abated by rest 
and the free use of barley-water. In some cases one injection 
sufficed to cure completely. If a relapse ensued the injection 
was repeated. A lady who had suffered for more than two 
years, and who was sounded for stone more than once, recovered 
after one injection. — Braithwaite, p. xxvii. p. 209. 

Dr. Boudin, in the Grazette Medicale, very highly recommends 
injections of the nitrate in what he calls follicular enteritis, by 
which he means typhoid fever, with inflammation and ulceration 
of the mucous membrane of the small bowels. He dissolved 
three or four grains of the salt in six ounces of water, and threw 
it up the rectum night and morning. Of fifty patients so treated 
only two died. Was it possible to know that the bowels were 
ulcerated in the forty-eight patients who recovered ? Here the 
remedy acted in part by counter-irritation. The report states 
that when gastric irritation was present a pill was given twice a 
day containing from a quarter to a half-grain of the nitrate. 

Nitrate of silver is a favorite application of Dr. Bennett to the 



USES OF LUNAR CAUSTIC. 183 

os tincce for the cure of inflammation, ulceration, or induration, 
whether in the single or married, where the disease is often very 
troublesome. The use of a speculum vaginae fixes the actual 
condition of the parts, and the lunar caustic is applied accord- 
ingly. Dr. B teaches that leucorrhoea, dysmenorrhea, &c. 

originate in the diseased state of the os tincae, as above, very 
often if not in all cases, and hence the importance of correct 
examination and the right use of the remedy. Dr. Ashwell 
thinks, however, that Dr. Bennett is mistaken, or that he has 
been disposed to make too much of a hobby of this view of the 
matter. 

Mr. Lloyd, of St. Bartholomew's Hospital, has cured many 
troublesome cases of prolapsus ani with nitrate of silver by 
smearing the caustic over the protruded gut and then pushing 
it up in place. It was rarely needful to make the application 
more than three or four times, and it was never followed by a 
bad result. In the worst cases the bowel was greatly swollen 
and the remedy soon gave relief. Hemorrhoidal congestion and 
thickening of the mucous membrane at the verge of the anus are 
also treated in the same way. — Med. Times and Gfaz., February 
10, 1855. 

The cure of fissure of the rectum has been accomplished mainly 
by nitrate of silver. The fissure is ascertained by the finger, 
which detects a callous rough spot an inch within the verge of 
the anus. The stick caustic being carefully passed up is applied 
to the spot as often as may be required. A single application 
affords relief, but several touches are required for permanent cure. 
This plan is strongly advised by Colles, in his work on surgery. 

Incontinence of urine is often cured by the use of lunar caustic. 
This disease may be congenital, and it is also the result of gene- 
ral bad health. When it is neglected in infancy, and remains 
till a female is about to enter into the marriage state, it be- 
comes an embarrassing affair, and relief is most earnestly sought. 
Duffin has reported interesting cases of this sort cured by the 
caustic. A young lady aged nineteen had long suffered from 
incontinence of urine. The stick caustic was applied to the 
meatus urinarius and excited high irritation there, so that great 
pain was felt the instant a particle of urine came in contact with 
it and the further flow was arrested. The irritation being kept 
up a few weeks the disease was radically cured. (See London 
Lancet, 1839-40, vol. ii.) 

Pereira speaks in praise of lunar caustic in the treatment of 
scald head. He says he never knew the remedy to fail, and 
adds that it does not cause permanent loss of the hair. He 
advises to rub it on the scalp after cleaning with a poultice of 
bread and milk ; and cautions against acting on the whole of the 



184 USES OF LUNAR CAUSTIC. 

diseased scalp at once, which might set up delirium, but advises 
the application in spots on successive days. 

Bretonneau and others employed the solid caustic to variolous 
pustules on the first or second day of eruption, in order to cut 
short their advance to maturity. The inflammation was thus 
arrested and scarring prevented. It is called the ectrotic or 
abortive treatment. As the face is the only spot where the 
scarring is dreaded, and as few pustules are found there in most 
cases, it has been proposed to cut off the apex of each eruption on 
the first or second day and gently to touch the spot with caustic. 
This is said to be the most certain method. 

Before I dismiss the external use I desire to call attention to 
the power of nitrate of silver to dissipate small hard tumors 
effectually. These are found on the nose or other parts of the 
face, and often excite alarm by their long continuance. Al- 
though they do not rapidly increase, sometimes they are painful, 
and the irritation is increased by picking and scratching. I have 
removed these lumps frequently by touching once a day, or once 
in three or four days, with the stick caustic moistened at the 
point. The tumors have almost insensibly vanished. A female 
was once advised by a friend to try this simple expedient and 
felt disposed to do so. The tumor was near the end of the nos- 
tril, was quite small, but growing very perceptibly. Her phy- 
sician objected strongly, talked much of the danger of setting up 
a malignant disease, and advised emetics and warm water as a 
topical application. The disease alarmingly progressed, and 
was at length cured by the well-known Judkins ointment ; thus 
proving conclusively enough that the idea of malignant degene- 
ration was a mere fancy. The tumor could have been wholly 
obliterated in less than three weeks by the nitrate of silver, and 
without any sort of ill consequence. 

It has fallen to my lot to have a number of cases of serious 
hemorrhage from the cavity left by the extraction of a tooth. 
Various expedients have succeeded, but I have thought the effect 
was more immediate and certain from a plug of nitrate of silver, 
cut to a point, forced into the cavity and covered with lint, which 
was kept in place by pressure of the jaws. The first suggestion 
in this relation, so far as I know, was made in the Med.-Chirurg. 
Rev. for October, 1841. 

The vesicant power of nitrate of silver is sometimes resorted 
to. Almost every article that is capable of setting up high irri- 
tation of the skin can be made ultimately to vesicate. Mustard, 
flies, acetic acid, ammonia, and nitrate of silver, agree in this 
feature substantially. To effect vesication the stick caustic is 
drawn very frequently in various directions across a spot moist- 
ened with a little water. When the impressions made by the 



INTERNAL USES. 185 

stick are sufficiently numerous, vesicles appear containing more 
or less serum. These are to be evacuated, and the operation 
with the caustic repeated if need be. The full effect is gained 
in from two to four hours ; and there is no unkind action in the 
urinary organs, as is sometimes seen after vesicating by canthar- 
ides. This mode of blistering is said to be well suited to diseases 
of the chest with too much febrile excitement to allow the use of 
flies. 

Before we notice particularly the internal exhibition of nitrate 
of silver we desire to say a word or two touching its application 
to the hair, as in hair-dyes, designed to change red into black 
hair. It is the physician's duty to inform himself on this point. 
He should know that meningitis has resulted from this employ- 
ment of nitrate of silver to the head. Delechamp reports a very 
interesting case of a most terrible headache in a young lady from 
the same cause. The facts are very important. In one of the 
volumes of the Journal de Chimie Medicale we find the follow- 
ing case : — A female who had red hair which she desired to ex- 
change for a more attractive color resorted to a fashionable hair- 
dye. She succeeded in making her hair black enough, but her 
skin was dotted with many very livid spots, which were quite 
painful, as the consequence of her achievement. The patient 
was directed to wash frequently with a strong solution of com- 
mon salt, and to drink a little of the solution occasionally. The 
spots and pain gradually disappeared under this treatment. 

The internal use of nitrate of silver was at one time and for 
many years almost wholly restricted to the management of epi- 
lepsy and chronic nervous affections. It is now resorted ; to on 
a much more extensive scale, and often with obvious advantage. 
We shall speak of it first, however, in respect of epilepsy, where 
it exerts atonic and alterative power conjointly, in all probability. 
Beginning with doses of the eighth of a grain for an adult, it may 
be gradually carried to almost any quantity. The remedy is so 
old that experience enough on this point has been had to satisfy 
us that even in very large doses the medicine may be a safe one. 
Decidedly the best way to make pills of this salt is to rub it first 
to fine powder, and to add enough of the soft extract of quassia 
or gentian to make it into pills. This combination not only 
makes a perfect pill, but presents a twofold tonic and alterative, 
which is often very desirable in chronic diseases. 

The chief danger of a protracted use of the nitrate, as in old 
epilepsy, consists in the discoloration of the shin that now and 
then occurs. We do not mean to say that large doses necessarily 
lead to this result, for facts speak a different language. In the 
fifteenth volume of the Edinb. Med. and Surg. Journal, we find 
the case of a patient who took one hundred and eighty-six grains 

13 



186 LUNAR CAUSTIC DISCOLORS THE SKIN. 

in twenty-six days, and with no discoloration at all. We infer 
that there is in the stomach or general system of one man such 
a state or condition as to insure discoloration from the long-con- 
tinued use of this remedy in large doses, which does not operate 
in the case of another patient who misses this cutaneous accident 
altogether. The medicine is precisely the same whether discolor- 
ations follow or not, and the rete mucosum does sometimes ex- 
perience such a deep tinge that it would seem to be unchangeable. 
The 3Ied.-CMr. Rev. for 1837 has the case of a man known 
in London as the blue man, because of the extensive and long- 
continued discoloration of his skin. He took the salt not only 
until it stopped his fits, but for several months afterward, so 
that in all he had swallowed several pounds of the medicine. 
This case is quoted with remarks by Pereira, Thompson, and 
others. 

The philosophy of this discoloration has never been satis- 
factorily explained ; and yet we are sure, from the well-known 
agency of the nitrate to blacken hair and linen, that the result is 
due to chemical action of some kind. What change the salt 
undergoes is not certainly known, nor is it plain that the dis- 
coloration depends merely on the change in the character of the 
salt. The stomach contains muriatic or hydrochloric acid, or 
salts with that acid, and this fact would seem to make the de- 
composition of the nitrate certain. That the salt is altogether 
decomposable in the human system is equally certain. Not only 
is it capable of separation into nitric acid and oxide of silver, 
but the oxide is reducible completely to the metallic state. We 
infer this from the reports of Wedemeyer and others, made in 
the London Med. Gazette, vol. iii., such as the following: — 
An epileptic was cured by the continued use of nitrate of silver, 
*but finally died of diseased liver and dropsy. A thorough post- 
mortem examination being made, it was ascertained that all the 
viscera were marked by a blue tinge ; and in the plexus choroides 
and pancreas Mr. Brande detected particles of metallic silver. 
This fact proves quite conclusively the agency of the vital forces 
to decompose the most perfect salts, and that this power is far 
more potent than the merely chemical agencies of the animal 
economy. 

We hinted at the removal of discoloration by nitrate of silver 
when we spoke of the pernicious effect of hair-dyes. We say 
further that no one should make this change in the color of the 
skin a valid objection to the use of the nitrate of silver when its 
curative powers are so well established, because it is not neces- 
sarily a permanent evil, even though it should certainly occur. 
Various washes have been successfully employed for the removal 
of the stain, such as strong solutions of cremor tartar, of hy- 



LARGE DOSES OF LUNAR CAUSTIC IN CHOLERA. 187 

driodate of potash, &c. Even diluted muriatic acid, citric acid, 
and strong vinegar have proved effectual. Perhaps the most 
certain is the iodide of potassium or hydriodate of potash. Two 
drachms dissolved in three or four ounces of water make a lotion 
which should be applied eight or ten times a day. 

Yery large doses of nitrate of silver have been given in the 
treatment of Asiatic cholera not only without injury, local or 
general, but with the effect of saving the patient. In the Med.- 
OJiir. Rev. for October, 1834, may be found the experience of 
Dr. Lever in the cholera which had just before been epidemic. 
He was in favor of unusually large doses of this article, even so 
large as to excite incredulity in some minds. He says he has 
given thirty grains dissolved in three ounces of water at one 
dose, and very frequently twenty-grain doses, and that ten grains 
constituted his more customary dose. He assures us that the 
vomiting and purging speedily ceased under this administration. 
I suppose the remedy acted by its constringing power on the 
patulous vessels, pouring out the serosity of the blood into the in- 
testinal canal, and also by its tonic quality. The theory, how- 
ever, is unimportant. A single real fact is loorth more than ten 
thousand theories. The only important question is this : Is it a 
fact ? The character of Dr. Lever, not less than the reputation 
of the journal which gave publicity to the statement, forbids even 
suspicion, unless we are led to suspect by our own actual experi- 
ment the truth of the announcement. I should have no fear of 
poisoning a patient by such doses as Dr. Lever administered, and 
no reasonable doubt can be raised on this ground. We must 
bear in mind that the stomach and bowels are in a morbid state, 
or at all events under the influence of grave morbific agency, so 
that an otherwise poisonous dose will operate only as a counter- 
irritant, and that so far from being deleterious may exert a most 
salutary influence. It is well known that the condition of the 
stomach has a decidedly controlling power in respect of articles 
held to be poisonous. 

The above statement is made in my lecture on Asiatic cholera, 
published in May, 1849 ; and I have learned that some persons 
doubted the accuracy of my quotation and were satisfied only by 
consulting the authority. Dr. Fithian, of New Jersey, has since 
informed me that doses larger than the books have suggested were 
employed by physicians in that State, not only in cholera, but to 
quiet high irritability of the stomach attending other diseases, 
and with very happy results. 

Somewhat different is the use of nitrate of silver in cholera 
infantum as respects the dose. The success of the medicine in 
fractional doses has long been known to the profession, and 
merits attention. In doses of from one-sixteenth to one-eighth 



188 OTHER USES OF NITRATE OF SILVER. 

of a grain, repeated twice or thrice a day, both infantile cholera 
and diarrhoea have frequently and speedily yielded. The astrin- 
gent and tonic property combine to give efficacy to the treatment. 

A German professor (Mauthner) speaks in very high praise of 
nitrate of silver as a remedy for infantile cholera. He orders 
an injection every hour of two grains in an ounce of distilled 
water, with a little oil. At the same time he gives, every four hours, 
a tablespoonful of a solution of one grain in two ounces of pure 
water. The mixture is readily taken and hardly ever sickens the 
patient. 

Prof. Graves, of Dublin, reports very favorably of one-grain 
doses of the nitrate three times a day in the diarrhoea of con- 
sumptive patients. He declares it to be more effectual than 
twenty grains of the acetate of lead. 

Dr. Hirsch, of Koningsburg, reports in Huf eland's Journal 
for 1847, the happy action of nitrate of silver in very minute 
doses in the diarrhoea of new-born infants. Besides an occa- 
sional enema, containing a fourth of a grain of nitrate of silver 
in mucilage of gum Arabic, and a very little opium, he used the 
following : — 

R-— Argent, nit. gr. \ ; 
Aquae, gij ; 
Pulv. gum Arab, ^ij ; 
Sacch. alb. gij. 

Mix, and give a teaspoonful every two hours. 

The good effects are obvious in a few hours, though sometimes 
not till the second or third day. Dr. Skinner, of North Caro- 
lina, gave to children between one and two years old one-six- 
teenth of a grain at first, afterward one-eighth, and sometimes 
a quarter of a grain. (See his paper in Amer. Journal of Med. 
Sciences.) 

Mr. Lyons gave the nitrate combined with opium in the treat- 
ment of yellow fever, with the design of allaying irritability of 
the stomach and bowels. He employed the combination after 
the black vomit appeared, and the a vomiting was arrested. The 
proportions were three grains of the nitrate to one of opium, 
made into a pill with conserve of roses. 

Dr. Johnson, in his admirable work on Morbid Irritability of 
the Stomach and Bowels, speaks in high terms of commendation 
of the nitrate of silver in small doses, as one-eighth or one- 
fourteenth of a grain, with a little vegetable bitter extract, taken 
twice or thrice a day. The tone of the mucous coat is soon im- 
proved, the digestive powers become more natural, and the gas- 
tric uneasiness is abated. I have employed this remedy under 
similar circumstances, and with great satisfaction. 

Dr. Ditterich, of Munich, advises the internal use of nitrate 



POISONOUS ACTION OF NITRATE OF SILVER. 189 

of silver for Menorrhagia, and also for the leucorrhoea "which is 
present during the intervals. His prescription is : — 

R. — Nit. argent, grs. iij ; 

Aquae, ^ij. 
Mix. 

Of the the solution ten drops are to be taken three times a day, 
gradually increasing the dose to fifteen drops. From four to six 
weeks are required for the medicine to act efficiently. In ten 
days the leucorrhoea sensibly diminishes; by the second men- 
strual period the catamenial flow is restored to its proper state, 
and all the nervous symptoms vanish. (See Northern Journal of 
Medicine, Dec. 1845.) 

Dr. Peebles has reported success with nitrate of silver in the 
treatment of jaundice ; but we feel inclined to doubt, as does 
Dr. Ranking in his Abstract, No. 10, whether this practice 
can be trusted. Dr. P. thinks the nitrate cures by modifying 
the state of the mucous membrane of the stomach and duodenum. 

The Dublin Medical Press contains an article on the nitrate 
of silver as a remedy for salivation. A drachm of the salt is 
dissolved in an ounce of pure water, and the solution is employed 
as a wash to the gums and mouth three or four times a day. In 
three days the salivation is Completely arrested. The only ob- 
jection to this remedy is the discoloration of the teeth. This is 
obviated by using a wash made by adding two drachms of hydrio- 
date of potash to an ounce of pure water. A brush should be 
used to clean the teeth, but the stains on the gums will subside 
by mere washing. (See Dublin Med. Press, Aug. 1849.) 

If a very large quantity of nitrate of silver be swallowed by 
a person in health, it will most likely induce symptoms of irri- 
tant poisoning. The free use of a saturated solution of common 
house salt will quickly decompose the nitrate and render it inert. 

In addition to the several qualities already assigned to nitrate 
of silver we add that it is also an antiseptic. The addition of a 
very small quantity will preserve water for a long time. 

The oxide and the iodide of silver have been employed as sub- 
stitutes for the nitrate, to avoid the accidental staining of the 
skin, of which we have already spoken. A writer in the London 
Lancet for July 10, 1841, has endeavored to show that for all 
the purposes to which the nitrate is appropriated the oxide is 
preferable, because it does not tinge the skin. It is made from 
the solution of the nitrate by the action of potash, which pre- 
cipitates the oxide ; this should be collected on a filter, washed, 
and dried. The adult dose is half a grain repeated twice a day. 

Mr. Bennet, surgeon, states that he has arrested uterine hemor- 
rhage, occurring before delivery, by the use of oxide of silver, 



190 ARMENIAN BOLE — ARSENIC. 

in the dose of half a grain twice a day for three or four weeks, 
occasionally intermitting for two or three days. (See London 
Lancet, May, 1850.) 

The iodide or ioduret of silver has also been substituted for the 
nitrate, because of its alleged failure to produce discoloration. 

The cyanide of silver has been exhibited in syphilis in the 
dose of one-tenth of a grain twice a day. It is said to be a very 
energetic medicine. 

Armenian Bole. — This article is inserted here not because 
of its intrinsic importance, but to give a hint that may be useful. 
During a most fatal epidemic scarlatina the only successful prac- 
tice was that of a notorious quack, who gave a secret powder, 
composed chiefly of Armenian hole, and really inert. Willan, 
who mentions the fact, says "the success did not depend on the 
action of the powder, but rather on the confidence inspired by a 
few successful cases." The lancet and purging were laid aside 
and the disease left very much to nature. 

Arnica Montana. Mountain Arnica. Mountain Tobacco. 
— The flowers, leaf, and root have been regarded as medicinal. 
It has been known to the profession at least as far back as 1719, 
when several dissertations were written concerning its medical 
properties. It was then very much overrated, and fell into dis- 
use ; nor is it likely ever again to hold an important place in the 
Materia Medica. The advocates of homoeopathy often speak of 
arnica as one of their remedies, not aware of its antiquity. Some 
of them make a hobby of this old novelty. 

Arnica was once suspected to contain strychnia, but numerous 
and accurate experiments proved its non-existence. The leaves 
and flowers are bitter and pungent, and contain some gallic acid. 
The ancient practitioners held it to be a stimulant of the nervous 
system, a diaphoretic, and an irritant of the digestive canal. 
They employed it also to discuss tumors and allay the irritation 
of bruises. Scopoli directed it to be used in the shape of poultice 
and tincture for these ends. Fehr called it a panacea. 

Nine cases of amaurosis are reported in vol. iii. of Duncan's 
Med. Commentaries as having been cured by two or three weeks' 
use of a strong decoction of the arnica. The usual remedies 
had been previously tried to no good purpose. 

We have many articles equally safe and decidedly superior, 
and hence the discredit into which it has fallen. It is one of the 
many things that will do no harm in moderate portions. 

Arsenicum. Arsenic. White Arsenic. White Oxide of 
Arsenic. Arsenious Acid. Rat' s-bane. — The pure arsenic is 
metallic, and must be distinguished from the article so commonly 
called by that name. The metal is of a grayish color, and 
possesses no poisonous quality. Its union with oxygen, consti- 



ARSENIC. 191 

tuting arsenious acid, gives rise to its energetic character in small 
portions and its poisonous action in an overdose. The native 
compound, called mispickel, consisting of arsenic and iron, both 
in the metallic state, was formerly administered as a medicinal 
agent. 

The white arsenic is properly called arsenious acid, because it 
unites with alkalies and gives rise to salts, as the arsenite of 
potash, which is the basis of Fowlers solution. 

The resemblance between the arsenious acid and calcined 
magnesia has led to serious mistakes. Frequently, though not 
always, the acid has an acrid taste, which might serve as a caution. 
It leaves in the fauces a peculiar metallic acrimony that never 
attends magnesia. It has no smell, but is heavier than magnesia. 
To guard against casualty, it should always be labeled poison, in 
large letters, and should never be sold excepting on the order of 
a physician or some well-known and responsible person. It is 
too easily procured by servants and others under the pretext of 
killing rats. 

It was at one time believed that arsenic spread on the earth's 
surface exerted a fertilizing influence, although not taken up 
by the vegetation grown thereon. It would seem, however, 
from the following statement, that the poison of arsenic is 
transmissible in vegetable matters, so as to exert a deleterious 
influence. 

In the London Lancet, Dr. Fuller, Lecturer on Medical Juris- 
prudence at St. Thomas's Hospital, mentions the following 
singular fact connected with the English practice of steeping 
wheat in arsenic before sowing it : — 

" For some months past, in certain parts of Hampshire, par- 
tridges have been found dead in the fields, presenting a very re- 
markable appearance. Instead of lying prostrate on their sides, 
as is usually the case with dead birds, they have been found 
sitting with their heads erect and their eyes open, presenting all 
the semblance of life. This peculiarity, which for some time 
had attracted considerable attention from sportsmen in the 
neighborhood, led to no practical result until about ten days ago, 
when a covey of ten birds having been found nestled together in 
this condition, two of the birds, together with the seeds taken 
from the crops of the remaining eight, were sent up to London for 
examination. 

"I was requested to undertake the investigation, and the result 
of my experiments I will now briefly detail. I first examined 
the seeds taken from the crops of the birds, and detected, as I 
anticipated, a large quantity of arsenic. Having thus ascer- 
tained the presence of arsenic in the food of the partridges, I 
proceeded to examine the birds themselves. They were plump 



192 ITS EFFECT ON VEGETATION AND BIRDS. 

and in good condition, but the oesophagus was, in both cases, 
highly inflamed throughout. The intestines were not inflamed, 
and presented no trace of ulceration ; but they were remarkably 
empty and clean, almost as if they had been washed with water. 
May this not have been the result of diarrhoea? I now, at 
the suggestion of my friend Mr. Stone, proceeded to ascertain 
whether the flesh of birds so poisoned might not of itself prove 
poisonous when eaten, and with this view I carefully cut the 
flesh from the breast and legs of one of the birds, and gave it, 
together with the liver, to a fine healthy cat. She ate it with 
avidity; but in about half an hour she began to vomit, and 
vomited almost incessantly for nearly twelve hours, during the 
whole of which time she evidently suffered excessive pain. After 
this nothing would induce her to eat any more partridge. 

" On examination the flesh of the birds was found to be full of 
arsenic. How did it get there ? In Hampshire, Lincolnshire, 
and many other parts of the country, the farmers are now in the 
habit of steeping their wheat in a strong solution of arsenic previous 
to sowing it, with the view of preventing the ravages of the wire- 
worm on the seed, and of the smut on the plant when grown ; 
that this process is found to be eminently successful, and is, 
therefore, daily becoming more and more generally adopted; 
that even now many hundreds-weight of arsenic are yearly sold 
to agriculturists for this express purpose ; that although the seed 
is poisonous when sown, its fruit is in no degree affected by the 
poison ; that wherever this plan has been extensively carried out 
pheasants and partridges have been poisoned by eating the seed, 
and the partridges have been almost universally found sitting in 
the position I have already described ; and, lastly, that the men 
employed in sowing the poisonous seed not unfrequently present 
the early symptoms which occur in the milder cases of poisoning 
by arsenic." 

In endeavoring to assign causes for the prevalence of diarrhoea 
and cholera morbus the editor of the Liverpool Journal says : — 

" The question here suggests itself, — May not poachers and 
game-keepers, finding birds so killed, gather them up and sell 
them ? Have not wheat fields been drained into rivers, and may 
not the drinking of the water have superinduced bowel com- 
plaints? May not the use of game lead to the same result? 
River-water has been considered objectionable where cholera 
prevails, and Dr. Sutherland, at Dumfries, has forbidden the use 
of the river-water, which is, however, exposed to the contamina- 
tion of sewers." 

The facts, as above detailed, commend themselves to the atten- 
tive study of medical men everywhere. Cases of unaccountable 



MEDICINAL USES OF ARSENIC. 193 

fatality are occurring in various places which might be explained 
by reference to the many uses to which arsenic is appropriated. 

Arsenious acid was formerly much employed prior to the 
introduction of the sulphate of quinine, and is certainly one of 
the best anti-periodics we possess. The best forms of adminis- 
tration are the solution and pill. The solution is usually called 
Fowler s solution, tasteless ague drop. Dr. Fowler first intro- 
duced this preparation, and published largely on its powers in 
intermittents and periodical affections generally. The article 
called tasteless differs from another preparation long in use, 
which contains the compound spirit of lavender and on which 
its color and taste depend. To make the tasteless ague drop, 
boil sixty-four grains of arsenious acid and sixty-four grains of 
carbonate of potash in six or eight ounces of water in a Florence 
flask, by means of a spirit-lamp. When the solution is complete 
and cold add enough water to make a pint. To form the other 
preparation, after boiling the solids in the water add enough 
compound spirit of lavender to make a pint. Some prefer to 
add two ounces of the lavender spirit to the pint, as the object is 
only to make the dose pleasant to the taste and agreeable to the 
stomach. Every fluidounce of either solution contains four 
grains of arsenious acid ; each fluidrachm contains half a grain. 
The dose of the solution for an adult is from ten to thirty drops 
three times a day. Thirty years ago five-drop doses were deemed 
sufficiently large, and were the maximum in the hands of the late 
Prof. Barton and others. But as diseases of all kinds mani- 
festly change in grade and force, so with the fevers for which 
this medicine has been employed. These will not yield to the 
five-drop doses once so popular. During the prevalence of 
fevers in Pennsylvania in 1819 and '20, I found it absolutely 
needful to use doses of fifteen and twenty drops three times 
a day or oftener. An account of this change in practice was 
given in the American Med. Recorder, and is noticed briefly 
in Eherles Therapeutics and the United States Dispensatory. 
Large doses were not only more speedy in their action but the 
results were more permanent. The more sudden the impression 
the better, and the large doses named are given with entire 
safety. I had a patient who was expecting his chill within an 
hour or two, but taking the phial in his hand to drop the dose 
into a teaspoon was seized just as he was measuring the dose. 
Instead of fifteen drops he filled the spoon, and in the hurry 
swallowed the whole at once. I called in soon afterward and 
found him a good deal agitated ; gave him a dose of Epsom salts 
and left him. On the next day he was seen again, and there was 
no return of chill, nor did the disease recur during the season. 



194 THE ORIGIN OF ARSENIC AS A REMEDY. 

As a general rule I have found that the solution succeeds best 
and soonest if it occasion a little sickness of the stomach and 
some little tumefaction of the upper lip and eyelids. For these 
results it is generally necessary to continue the use of the medi- 
cine for a week, or at least for five or six days. If it fail to 
induce the local symptoms named, or to give relief to the 
patient in any way, it may be regarded as not suited to the case. 
Obstruction of the liver or spleen, or of any of the organs, is an 
obstacle to the successful action of the medicine. An obvious 
advantage of the solution is that you can give it in the paroxysm 
as well as in the intermission ; and the same is true of remittents. 
The swelling, or oedema arsenicalis, is transient, rarely continu- 
ing more than three or four days, and seldom quite so long. 

The origin of the use of arsenic in intermittents, and febrile 
diseases with remission, is traced to the agency of the vapors 
of arsenical ores emitted from copper smelting works. Prior to 
the establishment of the Cornwall copper works the neighboring 
regions constantly abounded in intermittents. Since the regular 
operation of the works the periodical fevers ceased, and the 
workmen say "the smoke of the work kills all fevers." It is 
part of the history that no agricultural or other improvements in 
the vicinity can account for the change. 

I have administered the medicine in form of pill, in the dose of 
an eighth of a grain ; and in obstinate intermittents I have given 
as much as the fourth of a grain. This form prevents the detec- 
tion of the medicine by the patient who has been using the solution 
containing the compound spirit of lavender. It will sometimes 
cure old intermittents, when combined with sulphate of quinine, 
that have resisted the latter remedy alone. 

The following statistics are important, as they show the success 
of arsenic, contrasted with that of the sulphate of quinine, in the 
treatment of intermittents. They are taken from Ranking' s 
Abstract, vol. ii. No. 2, page 184, and were made in the Hospital 
of Versailles. 

Of 142 patients who took no sulph. quinine nor arsenic, 8 relapsed. 
Of 111 do. treated with do. do. only, 11 do. 

Of 311 do. treated with arsenic, 10 do. 

One-third of the 311 cured by arsenic had previously taken sul- 
phate of quinine without relief. 

Dr. Darwin administered arsenic successfully to a patient in 
whose heart there was an intermission of pulsation once in every 
three or four beats. Four drops of a saturated solution of arse- 
nic constituted the dose three times a day. As there is obscurity 
in this title of the medicine, physicians who feel disposed to give 
it a trial had best employ the Fowler's solution in the same dose. 
The cases to be thus met will prove to be those in which there is 



USES OF THE FOWLER'S SOLUTION. 195 

no true organic heart affection. The intermission may be neu- 
ralgic, or sympathetic from the condition of the stomach. 

Porrigo, lepra, eczema, and other very obstinate diseases, have 
been radically cured by the use of arsenic. I well remember a 
case that occurred in the Pennsylvania Hospital in 1810, and for 
which the late Prof. Barton ordered Fowler's solution in five- 
drop doses three times a day. It was designated as leprosy. 
The patient was kept in a cell remote from the other patients, 
and the scales gathered from his body were measured from time 
to time by Samuel Coates, Esq., who was then the most efficient 
manager of the establishment. The quantity of the scales was 
incredibly large. The man recovered, and was discharged well. 

Dr. Thwaites, of Edinburgh, introduced a new mode of admi- 
nistering the solution in old cutaneous affections, which I have 
tried with success in many cases. After reducing inflammatory 
action, if present, he began with doses of two or three drops 
thrice a day, increasing gradually to eight drops, or till fullness 
of the eyelids, swelling of the feet, &c. was obvious. Then the 
dose was gradually decreased to the original quantity, and after 
an intermission of four or five days the medicine was employed 
as before. There is decided advantage in the intermission of a 
few days, not only in respect of this medicine, but of others. 
The susceptibility of the system is thus revived and the power of 
the medicine thereby more efficacious. 

I had a remarkable case illustrating the value of this practice. 
A young gentleman had been afflicted for years with herpetic 
disease of the eyelids and hands, for which he had been treated 
with mercurials and other active means to no good purpose. 
The plan of Thwaites struck me as suited to the case, and it was 
tried with complete success. Since then I had frequent opportu- 
nities of testing the value of the practice, and can very cordially 
recommend it to the profession. 

A very interesting case of psoriasis inveterata is reported in 
vol. iv. of the Amer. Journ. of Med. Sci., cured by the solution. 
The eruption was scaly and itching to a most distressing degree, 
and for years had resisted other treatment. Though the general 
health seemed to be good, the eruption affected nearly the whole 
body. The patient was at first bled and purged smartly, and 
then four-drop doses of the arsenical solution were given three 
times a day, gradually increasing to twelve drops at a dose. The 
scales fell rapidly, and in four weeks he was cured. . The only 
additional remedy employed in this case was an occasional vapor 
bath. This is a good adjunct in all cutaneous diseases of long 
standing. 

Many interesting cases of old skin diseases cured by Fowler's 
solution of arsenic are recorded in the London Lancet for April, 



196 MODUS OPERANDI OF ARSENIC. 

1846. Prurigo scroti, prurigo pudendi muliebris, lepra vul- 
garis, lepra alphoides, psoriasis diffusa, psoriasis inveterata, 
psoriasis guttata, are named ; and some of the cases were very 
old, yet soon cured by the arsenic. 

That very obstinate and unsightly disease called gutta rosacea, 
or rose-bud face, has been cured by Fowler's solution. A case 
is reported in the London Medical and Physical Journal, treated 
with eight drops three times a day, gradually increased to twenty- 
five drops. In three weeks the nose regained its natural ap- 
pearance. 

In Wood's Quarterly Retrospect for Jan. 1848, it is stated 
that Fowler s solution of arsenic is an excellent medicine for 
cases in which successive crops of boils make their appearance, to 
the sore annoyance of the patient. From five to ten drops three 
times a day in a bitter infusion would be the proper dose for an 
adult. This cutaneous affection is seen occasionally as a sequel 
of fever, and is often very perplexing. 

The solution of arsenic has been employed in the treatment of 
snake-bites, and as these cases may frequently require medical aid 
in our new settlements it is well to know the facts referred to. 
A practitioner who went to the island of St. Lucie had occasion 
to test the arsenical practice, and found it quite successful. He 
gave one-grain doses of the mineral, as it exists in Fowler's solu- 
tion, every half-hour, till the patient began to revive. Five cases 
were treated in a short time with perfect success. The men 
took severally six, seven, and eight doses of the following pre- 
scription ere the arsenic began to vomit or purge. No trace of 
poisonous agency was perceptible. Mr. Ireland prescribed thus : 

R. — Liq. arsenical, gij ; 
Tinct. opii, gtt. x ; 
Aq. menth. pip. ^iss. 
To which an ounce of lime juice was added. 

Embrocations and clysters were also employed, but the cure 
was effected by arsenic. 

This is perhaps the most heroic arsenical practice on record. 
It was poison versus poison, and the stronger triumphed. 

In the Med.-Chir. Rev. for Oct. 1841, we find a novel use of 
arsenic furnished by Trousseau. Arsenical cigars are prepared 
from fifteen grains of arsenite of potash dissolved in a half-ounce 
of water. A sheet of paper is soaked with this solution, well 
dried, and then rolled up in form of cigars, having first been cut 
into slips of proper width. The patient draws in a large mouth- 
ful of the smoke and inhales it as deeply as he can. At first a 
good deal of coughing is excited, but the irritation soon subsides. 
This form of medication has been employed in periodical neu- 
ralgia of the face with benefit. 



MODUS OPERANDI OF ARSENIC. 197 

Dr. A. T. Thompson states that the action of arsenic is liable 
to exacerbations and remissions, and sometimes to intermissions. 
Thus we may suppose that there is a certain degree of analogy 
between its operation and that of the malarious poison, by virtue 
of which it may perhaps exert a corrective power over the work- 
ing of the latter in the blood. — Mat. Med. p. 185. 

It is best in all cases, says Dr. Headland, to give this medi- 
cine after a meal, on a full stomach, as then it is less likely to 
irritate, not coming directly in contact with the coats of the sto- 
mach, and being diluted by the food during its absorption. 

Touching the use of arsenic in the form of paste and ointment 
there has been diversity of opinion. Some have rejected both 
on the ground of injurious consequences of a poisonous nature. 
But it is probable that neither would do harm if applied to the 
sound skin ; and it is certain that Dupuytren has often applied 
an ointment of four parts of calomel and ninety-six of arsenic 
to malignant ulcers with advantage. 

There have been various notions entertained as to the modus 
operandi of arsenical preparations. By some a tonic property 
has been contended for, and yet we have seen nothing in the use 
of the remedy to justify that view of the matter. That it proves 
an alterative is beyond doubt true, and especially does this appear 
in its employment in skin diseases. One writer contended for 
its sedative action, but we are satisfied that he was mistaken. 
The antiperiodic property is undoubted, and it is probable we 
have not a medicine more decidedly exhibiting this character ; 
and it may be that some alterative action precedes the develop- 
ment of the antiperiodic effect. As before stated, Dr. Headland 
regards arsenic as a catalytic hcematic, correcting the blood 
poison, or so modifying it as to secure its final removal from the 
system. 

By far the most important inquiries of medical men touching 
the nature and effects of arsenic relate to its poisonous operation. 
This has been hinted at already; but as it is very necessary for 
the physician to be able to apply the more common and simple 
modes of investigation for the detection of this poison we pro- 
pose to speak somewhat in detail on this point. Every medical 
man is liable to be brought into court to testify in matters of 
this kind, and such is the ignorance of many practitioners that 
their testimony is calculated to inflict deep disgrace on the entire 
fraternity. We believe, therefore, that what we have to offer on 
this special matter may conduce not only to the welfare of society 
but tend to elevate the medical profession. 

Before we notice the poisonous action of arsenic it is proper 
to speak briefly of its obvious qualities. It is white, and there- 
fore distinct from metallic arsenic, which is of a grayish-black. 



198 MISTAKEN FOR MAGNESIA. 

It has a specific gravity of 3.7, and therefore should not be con- 
founded with magnesia, which is very light. It volatilizes at 380° 
or a little above that temperature, emitting a garlic smell and 
white fumes. To do this experimentally, throw a little on burn- 
ing coals, and the fumes and smell will be obvious ; this is stated 
because if it were thrown on red-hot pure iron it would hardly 
give these results. The presence of carbon is necessary in order 
to deoxidize the arsenious acid and revive the metal, whose com- 
bustion it is that gives rise to the smell and fumes. Arsenious 
acid is quite soluble in hot water, but dissolves in small quan- 
tity in cold water. A thousand parts of water at 60° will 
take up two and a half grains in twenty-four hours. At boiling 
heat seventy-seven and a half grains will be dissolved, of which 
forty-seven and a half fall on cooling. It is important to re- 
collect the difference in solubility, as here stated, since it helps 
to explain the failure of many attempts to poison wells and 
reservoirs of water ; and it teaches also the importance of em- 
ploying boiling water in examinations of substances or mixtures 
supposed to contain arsenic* 

The possibility of confounding arsenious acid with calcined 
magnesia was hinted at ; and it is proper to say that a lady of 
one of the most respectable families in Philadelphia lost her life 
by this kind of mistake. A servant was directed to bring a tea- 
spoonful of calcined magnesia from a closet where medicines 
were kept, the lady wishing to take it to relieve an acid stomach. 
Unfortunately a bottle of rat's-bane had been placed in the same 
closet, and from it the girl took the quantity directed. Very 
soon after swallowing the dose suspicion was raised by the feel- 
ing in the throat that all was not right. The styptic sensation 
increased, with burning in the stomach, which led the family to 
send for the nearest physician, a very respectable medical man, 
but wholly behind the actual state of the profession. He gave 
the lady water, as hot as it could be swallowed, in large quan- 
tities, hoping no doubt to evacuate by vomiting. But the hot 
water rendered the poison more active by dissolving it, and she 
fell a victim, most probably, to unwise management. Had a 
stomach-pump and tepid water been employed freely, the poison 

* The national perturbation induced by the poisoning of so many individuals 
in public life, at the National Hotel, in Washington City, a few months since, 
has invested the subject of arsenical poisoning with vast interest. Many valu- 
able lives have been sacrificed somehow, and it is very desirable that a full and 
complete solution should be given to the problem which is yet shrouded in 
mystery. Was it not a case of compound arsenical poisoning on a mammoth 
scale, putrid rats entering largely into the melee ? If somebody killed rats by 
the thousand with pounds of arsenious acid, and these rats found their grave 
in the great water-tank of the National, we have something like a stand-point 
for observation and inference. But who will disclose the reality of the case ? 



THE POISONOUS DOSE VARIABLE. 199 

might have been sufficiently dislodged to have saved her. even 
though the usual antidotes had been forgotten. 

How much of this article will kill a person, or display the 
veritable signs of poisoning ? To this query we reply that very 
much will depend on the actual condition of the patient, both as 
to his general system and also in respect to the stomach, while 
not a little is due to habit in our attempts to solve the problem. 
It is reported that two grains (and probably a less quantity) 
have killed an adult. But Dr. Perrine swallowed a drachm at 
once, and yet got well. His case is furnished in detail by him- 
self in the American Journal of Medical Sciences for 1832. 
He intended to have taken some bark and calcined magnesia, 
but his pupil added arsenious acid in place of the latter. The 
dose was swallowed early in the day, and the doctor started in 
his gig to make his usual visits. The presence of the bark no 
doubt retarded the deleterious action of the arsenic ; but after 
having rode about four or five hours he found himself so un- 
comfortable that he rode home as fast as possible. The mistake 
was discovered, and by the course of treatment which he details 
he recovered with very little loss of time. 

The London Medical and Surgical Journal gives the case 
of a Tyrolese peasant who took daily in his food ten grains of 
arsenious acid without injury. This was a very singular habit, 
and as remarkable for the power of endurance and freedom from 
suffering. It may be that this man's stomach had lost its sensi- 
bility by the previous use of opium and other stimulants. 

A child was poisoned by eating paste made for killing rats. 
The child died, and the only special item in the case was that, 
although but twenty months old, very natural sleep occurred and 
continued for about three hours and a half after the paste was 
swallowed. — Ranking, vol. i. p. 324. 

A workman engaged in the manufactory of arsenical candles 
had an abrasion on one hand which probably introduced the poison 
and led to a fatal result in a few days. — Ranking, vol. i. part 1.* 

The Provincial Med. and Surg. Journal for January, 1842, 
relates the case of a young man aged seventeen who took two 
drachms of arsenic with a view to self-destruction. He repented 
the act, and made disclosure in a quarter of an hour. As soon 
as practicable six grains of tartar emetic were administered, and 
an additional dose soon after. Vomiting at length came on, and 
was kept up by the use of warm water for the space of two hours. 
Nothing remained on his stomach for hours. He complained 
of severe gastric and intestinal pains, was bled and purged by 
injections. A blister was applied to the epigastrium, and effer- 

* Very recently we have learned that the arseniate of copper on wall-paper, 
in a sitting-room, has induced mild symptoms of arsenical poisoning. 



200 SYMPTOMS OF ARSENICAL POISONING. 

vescing draughts occasionally administered. In a few days he 
was as well as usual. 

The symptoms visible in several cases of arsenical poisoning 
in the same house, at the same time, are various, and go to prove 
that the article is a narcotico-acrid poison, or an irritant and 
narcotic combined. If the individual who has taken the poison 
be an intemperate man, the sensibility of his stomach very much 
blunted, he may realize nothing worse than a smart attack of 
colic. In other persons the same dose would develop mortal 
symptoms. There is almost always a sensation of heat and 
acrimony in the mouth and throat, spasmodic pains of the sto- 
mach and bowels, constriction of the oesophagus and whole ali- 
mentary canal, increased flow of saliva, inflammation of the 
eyes, itching of the face and neck, vomiting and purging, some- 
times bloody discharges, now and then great prostration of the vital 
forces, cold sweat, pulse scarcely perceptible, great anxiety and 
distress in the countenance, purple spots on the surface, the whole 
frame convulsed. All these features will not be seen in each 
separate case that may occur, but I have seen them all in a 
family of six persons, under the poisonous influence at the same 
time. 

Some persons have supposed that the symptoms of arsenical 
poisoning are very much like those of milk sickness, and hence 
this disease has been attributed falsely to the agency of arsenic. 
I have examined water brought to me a distance of fifty miles 
to determine whether or not it was impregnated with arsenic. 
Men and women and cows had sickened, and in some instances 
died, as was conjectured, from drinking the water. 

It is proper to remark that in persons having the slightest 
paralytic predisposition, the poison greatly develops that pre- 
disposition; and although life may be prolonged for months, 
death will finally ensue from general palsy. Nor is it unlikely 
that this result may sometimes follow arsenical poisoning, where 
there is no tendency in the system to palsy, or at least none that 
is apparent. 

The remedies or antidotes for arsenical poisoning have been 
quite numerous. By an antidote we understand some substance 
which, by the chemical change it is capable of exerting on the 
arsenical matter, destroys its poisonous quality or very greatly 
enfeebles it. In this view, some of the articles employed at 
various periods do not merit the name of antidotes, and can at 
most be regarded only as remedies of greater or less power. 
Milk, oils, soap, demulcents, and other articles equally feeble, 
were the only expedients resorted to for a long while, if we 
except attempts to empty the stomach by vomiting. None of 
these can be called an antidote, in the proper chemical sense. 






ANTIDOTES AND REMEDIES FOR THE POISON. 201 

There can be no doubt that free vomiting, followed by the above, 
or vinegar, or lemon juice, may be effectual; but we should not 
feel disposed to rely on them. 

Magnesia has long been employed to counteract the poisonous 
operation of arsenic. Some have regarded it as a remedy 
merely, while others esteem it an excellent antidote, in the true 
sense of the term. Bussy has insisted on its antidotal power, 
and others have, like him, contended for the formation of an 
insoluble arsenite of magnesia, by chemical union with the 
arsenious acid. Many who gave the article in milk thought 
that this fluid, by its coagulating power, enveloped the arsenic 
and so protected the stomach. The mention of coagulation 
brings to mind a curious story told of a girl in whose stomach 
was found a sac containing an ounce of arsenious acid; it is 
conjectured that milk was employed in that case, which involved 
the arsenic in a coagulum, while inflammatory action threw out 
coagulable lymph to form the sac in which it was found enclosed. 
The girl recovered from the first effort, but fell a victim to a 
second experiment, made after the lapse of a year from her first 
arsenical adventure. 

The best calcined magnesia is said to answer much better than 
the carbonate, and it may be given in milk almost ad libitum. 

Finely pulverized charcoal is, as I know from actual expe- 
rience, capable of accomplishing all that is desirable in this rela- 
tion, no matter whether it be regarded as a remedy or as an 
antidote. In determining the powers of charcoal Bertrand 
acted the part of a hero, taking five grains in an emulsion made 
with charcoal, with no unfavorable result save a little spasmodic 
pain, which soon passed off. We know that arsenious acid is 
decomposed out of the body by charcoal and reduced to a me- 
tallic state, in which it is harmless. Why may it not be so 
changed in the stomach? Christison thinks it acts merely by 
precipitating the arsenic from its solution, not doubting at all 
that it does really nullify the poison; but his explanation is 
wholly unsatisfactory, as mere precipitation could not change 
the essential quality of the arsenic. 

In a family (that of Dr. Hays, of Cincinnati) consisting of 
five persons, I employed the charcoal because there was a large 
quantity of it in the house and no other article as proper for 
the occasion. It was given by the mouth, in water, and molasses 
and water and milk, as fast as it could be taken, and also ad- 
ministered by injection. All the symptoms before named were 
found in this family, though each case was different in some re- 
spects from every other. All the persons poisoned were soon 
restored save the father of the family, in whom there had been 
slight tokens of palsy for several months. That disease was 



202 TREATMENT OF ARSENICAL POISONING. 

greatly aggravated, and soon became universal, terminating in 
death at the end of twelve months after the poison was adminis- 
tered. From the knowledge subsequently obtained the family 
must have swallowed very little less than half an ounce of the 
poisonous substance. This affair was made a matter of judicial 
investigation, and the negro who administered the poison was 
sentenced to fourteen years' imprisonment. The case is noticed 
in my Elements of Chemical Philosophy. 

Tobacco is next named rather as a remedy than as an anti- 
dote. The standard works are silent on this part of the subject, 
and, as I think, unwisely so. The whole history, brief as it is, 
commends itself to the consideration of all medical men. How 
the remedy acts is, of course, not certainly known ; but that it 
does act a salutary part is known, and this is by far the most 
important feature in the case. My own opinion is, that when 
it comes in contact with the arsenious acid a tertium quid is the 
result; a sort of compound poisoning, in which the original 
poisonous quality of both articles is lost. Christison furnishes 
many cases in point ; as, for instance, the mixture of laudanum 
and corrosive sublimate, both of which separately will poison, 
while the compound has failed to do serious harm. The first 
notice of the use of tobacco for the end stated appeared in a 
country paper in New England, and was copied into volume 
thirty-one of Sillimans Journal; and several other cases of the 
same nature were subsequently reported on the highest authority. 
In the first case, that of a young lady, the poison had been 
taken by mistake, and in a region considerably remote from a 
physician or an apothecary shop. It was supposed that an 
emetic would give relief, and as nothing offered excepting to- 
bacco it was resorted to in the hope of exciting vomiting and 
thus dislodging the poison. A decoction or infusion was pre- 
pared and rather cautiously exhibited, fearing it might act with 
too great violence. Dose after dose was given, and time passed 
away and no emesis could be had, and the result was that the 
lady was not seriously injured. The success of the new remedy 
led to its employment in the other cases referred to and with 
equal success, but in every instance there was no vomiting. All 
the patients were females, and unaccustomed to tobacco, and 
this is an important part of the history. It is more than proba- 
ble that an inveterate chewer of tobacco could not be saved by 
the exhibition of any quantity of this article. In the cases re- 
ported I take it for granted that the tobacco and the arsenic 
united to form a new and inert compound, for it is known that 
an infusion of tobacco would develop more or less of poisonous 
action in stomachs unused to its influence just as certainly as 
arsenic would. The facts as above were referred to in my 



THE BEST ANTIDOTE. 203 

Elements of Chemical Philosophy, published in Cincinnati in 
1832. 

*The hydrated peroxide of iron, for a few years past, has been 
regarded by many as the antidote by pre-eminence. For a time 
there was some discrepancy of opinion as to its powers, but as 
experiments were repeated in various parts of the world confi- 
dence was more and more settled in its favor. This antidote 
was prepared first by Bunsen, a German, who made it thus: — 
Four ounces of iron filings added to eight ounces of aqua regia 
(or nitro-muriatic acid) were gently heated in a glass vessel 
until the solution was complete. Then sixteen ounces of water 
were added, and subsequently by slow degrees three ounces of 
aqua ammonia, to throw down the oxide of iron. The whole 
mixture was next well shaken and filtered, the mass on the filter 
being well dried for use. This oxide is evidently a peroxide, 
and is called hydrated peroxide or hydrated oxide. For further 
particulars see the American Journal of Pharmacy, volume for 
1839, page 266. . 

The usual adult dose of this preparation of iron is an ounce, 
but there is no danger of a larger quantity. The proper course 
is to administer, by the mouth and by injection, as much as can 
be given, either in barley water, thin starch, or gruel. Macla- 
gan says that twelve parts of the peroxide are required to neu- 
tralize one of arsenic, and advises to give a teaspoonful every 
five or ten minutes when it is known that a large quantity 
of arsenic has been swallowed. The irritation thus excited 
almost always sets up active vomiting, and thus the poison 
with the antidote is ejected. If vomiting should not come on, 
or be inefficient, it would be needful to employ the stomach- 
pump. 

The chemical change induced by the hydrated peroxide of 
iron is the formation of an insoluble arsenite of iron, which is 
inert. The successful action of the antidote could be shown by 
the citation of cases almost without number. The following 
may suffice : — A man in a fit of delirium tremens took nearly 
two drachms of arsenic. In a half-hour subsequent to the act 
he took the antidote freely, so that in less than twelve hours 
about five ounces were disposed of. The result was, at the end 
of twenty-four hours he was as well as usual, having suffered no 
very severe pain. 

In all cases of arsenical poisoning it is well at once to fill the 
stomach with milk and water, or demulcents, and to provoke 
vomiting, so as to empty the organ as much as possible. Then 
the antidotes already named will be administered with greater 
probability of success. 

In all cases of poisoning, whether the person poisoned is re- 



204 t DETECTION OF THE POISON. 

stored or dies, it may be necessary for the physician employed 
in the case to give evidence touching the nature of the poison- 
ous agent. He must be able to detect its presence, and as *it 
may appear under various aspects it is his duty to be familiar 
with them all. Parcels of brown and white sugar have been 
sent to me, over and again, suspected of combination with poi- 
son, and especially with arsenic. If the brown sugar be care- 
fully inspected small white particles may be seen, which, on being 
detached and collected, can readily be tested by burning coals, 
as formerly stated. Thus I have in a few minutes demonstrated 
the presence of arsenic in brown sugar. It is not quite so easy 
if the sugar be white, because then the contrast of color is ab- 
sent. A simple experiment will soon show how much, if any 
arsenical matter is present in the sugar. Add small quantities 
of cold water until it dissolves all the sugar, pour off the solu- 
tion, and the arsenic, if there at all, will remain at the bottom 
of the vessel and can be tested in the way to be detailed pre- 
sently. When the arsenic has been added to coffee it may be 
seen in the mass, in white particles, which on being detached 
and placed on burning coals will give the garlic odor and fumes. 
Besides the above expedients to determine the presence of 
arsenic it is sometimes necessary to examine the matters ejected 
from the stomach or found in the dead body. And before we 
enter on this part of the subject it is important to attend to an 
item that demands special consideration. How long after the 
death of an individual may the presence of arsenic in the body 
be satisfactorily made out? It will be recollected that hydro- 
cyanic acid cannot be detected after a longer lapse than seven 
days, because of its ready decomposition and comparative vola- 
tility. But in respect of arsenic the opposite qualities obtain, 
so that it is not easy to assign any period beyond which its de- 
tection is impracticable. The mineral origin and nature of 
arsenic give it a kind of perpetuity that forbids its disappear- 
ance spontaneously, while its antiseptic property preserves the 
stomach and other organs in a condition that favors the detection. 
The case on record which presents the longest period between 
death and detection of the poison shows that fully seven years 
had elapsed. The arsenic was found in large quantity, and the 
stomach was nearly entire and of the usual form. Cases have 
occurred in this country in which from four to fifteen months 
elapsed from the date of poisoning and the death of the victim 
to the actual detection of the arsenic. The antiseptic quality 
and the indestructibility of the poison render its discovery in 
the body almost a matter of certainty, even though twenty 
years should pass away before suspicion should lead to examina- 
tion. 



DETECTION OF THE POISON. 205 

I am aware that a great deal was said in the progress of the 
celebrated Laffarge case in France, some years ago, about the 
presence of arsenic in the human system as a natural constituent, 
and also of its presence in the glass tubes employed in experi- 
ments made in that case; and I remember that these quibbles 
were raised expressly to save a guilty woman from merited pun- 
ishment. If the doctrine then laid down by a distinguished 
chemist had been sustained by the court, it would have made a 
precedent whose operation, all the world over, would have been 
to shield and protect the most abandoned murderer charged with 
the crime of arsenical poisoning. 

Another feature in this subject calculated to embarrass inves- 
tigation a little is the allegation that in a case of real and fatal 
poisoning by arsenic the poison may not be found in the stomach 
nor intestines, but may be detected in the liver and in some other 
parts. 

It is well to bear in mind that all quibbles are worthless as to 
the native presence of arsenic in the economy when we find it 
actually present in the stomach or bowels in quantities so large 
as to yield the most satisfactory proofs on the application of the 
more ordinary tests. When such proofs are not conclusively 
reached, humanity and common sense dictate the propriety of 
erring, if at all, on the side of mercy. 

I will suppose the case of a man poisoned, or supposed to be, 
with arsenic, the discharges from whose stomach have been col- 
lected in a glass vessel and allowed to settle. It is seen that 
at the bottom of the glass a quantity of grayish-white pul- 
verulent matter has collected. As yet you know not what it 
is. But all the symptoms of the case were those peculiar to 
arsenical poisoning, and there are, perhaps, other circumstances 
leading you to believe that the precipitate in the glass vessel is 
really arsenical. 

The first thing to be done is to collect this pulverulent preci- 
pitate on a filter, which can be accomplished by carefully pour- 
ing into another vessel all that is above. Let the wet powder 
be placed on a filter and allowed to dry, after which collect and 
preserve it for examination by the liquid tests, and also by the 
reduction process. The liquid tests to which I refer are the 
ammoniaco-nitrate of silver and ammoniaco-sulphate of copper, 
the former giving a yellow, the latter a green, precipitate. To 
make these tests, dissolve nitrate of silver and sulphate of copper 
in two separate bottles containing pure water, so as to make 
concentrated solutions. Add first to one and then to the other 
bottle the liquid ammonia until it begins to make the solution a 
little turbid. Then stop each bottle perfectly tight, and it is fit 
for use. It is proper to have at hand half a dozen glass rods 



206 THE USUAL TESTS. 

from six to nine inches long and a quarter-inch thick, hollow or 
solid, as the case may be, and, besides, some clean watch-crystals 
or pieces of clean white writing paper. 

Then take half of the dried pulverulent matter collected as 
above and boil it in pure water, in a clean glass vessel, by 
means of a spirit-lamp. A very few minutes will suffice, because 
if the powder be arsenious acid the whole will thus be held in 
solution. Dip a glass rod into this liquid and drop what adheres 
to it on two watch-crystals or two pieces of white paper, then 
dip rods into each of the liquid tests (one in each) and let fall 
a single drop on the crystals or pieces of paper. If the solution 
contained arsenious acid the silver test will strike a bright yellow, 
while the copper test will give a green, and these operations being 
repeated two or three times will fix the results more perfectly in 
the mind. 

As there is a possibility of deception here, and as the life of 
an individual may, to some extent, depend on the experiments 
made, it is very important to confirm or nullify the results as 
above stated by what has been called the reduction process. 
And it may be well to remark that this is a very simple affair, 
and every physician who desires to excel in such investigations 
should make himself familiar with the subject by repeated expe- 
riments with variable quantities of arsenious acid. 

In conducting the reduction process we take the residue of 
the pulverulent mass spoken of already and mix the whole or a 
part with an equal quantity of black flux, or fine powder of char- 
coal. Let them be well rubbed together and placed midway in 
a clean glass tube four or five inches long and three-eighths of 
an inch thick. Fit a cork tight to one end and have a soft plug 
of cotton for the other, so as to arrest the passage of vapors. 
A spirit-lamp being kindled, the tube is held by the operator 
with the cork end lower down than the cotton extremity, so that 
the tube shall exhibit an inclined plane and the blaze act on the 
mass in the centre of the tube. In a minute or two a metallic 
crust is deposited by sublimation on the upper side of the tube, 
having the sparkling appearance of antimony, though, perhaps, 
a little darker colored. It is evidently metallic, and has re- 
sulted from the decomposition of a metallic oxide or a metallic 
acid by the reducing power of the carbonaceous matter blended 
with it. The question to be decided is, what is the nature of 
this metallic crust ? Is it arsenic, or is it some other metal ? 

To decide this important question we take the tube and re- 
move the cork and cotton ; then, with a file drawn across mid- 
way, we prepare the way for an easy fracture of the tube into 
two parts, carefully detaching all the metallic crust with a fine 
penknife, and collecting it on clean white paper or in a dry 



THE KEDUCTION PEOCESS. 207 

watch-crystal. No matter how small the quantity of this crust, 
it will suffice. Divide into two equal parts, adding to one in a 
watch-crystal a few drops of water and a drop of diluted nitric 
acid. Hold the glass for a minute or two over a spirit-lamp to 
dissolve the crust, and try the solution with the silver and cop- 
per tests, as before detailed. If the bright yellow and the green 
colors be struck, your first experiments are confirmed. Drop 
the other half of the crust on a red-hot iron plate or on burn- 
ing coals, and if the garlic smell and fumes appear the presence 
of arsenic is established. With such prpofs no man need hesi- 
tate a moment in appearing to give testimony before a court and 

jury. ? »"".■■'; 

Marsh's hydrogen lamp test is very satisfactory, but not 
always at the command of country practitioners, and it is by no 
means indispensable. The process of Reinach, as given in No. 
31 of the British and Foreign Medical Review, is much more 
feasible. Copper foil cut into pieces an inch long and one- 
eighth of an inch in width, or fine copper gauze, must be heated 
almost to boiling. Then a very little muriatic acid (a one-six- 
teenth part) is' added to the supposed arsenical solution, and 
speedily it is decomposed, a thin steel-like coating of metallic 
arsenic being deposited on the copper, which may be separated 
from it again by dissolving it off with nitric acid, or by heating 
in a tube, when it will sublime in the form either of a ring of the 
metal or as sparkling crystals. These may be dissolved and the 
liquid tests applied. The process is said to be so delicate as to 
detect one-two-hundred-thousandth part of arsenic. 

In cases where the stomach presented no pulverulent matter, 
it, as well as part of the small intestines, having been cut into 
small pieces, should be boiled in pure water for half an hour. 
Let the whole be filtered while warm and the solution be tested 
before it becomes cold. This expedient is based on the fact that 
arsenical matter may be lodged in the folds of the mucous mem- 
brane so as to escape observation. Boiling in pure water will 
reveal its presence if it be there, and the liquid tests are com- 
petent to decide that point, especially if corroborated by the 
reduction process. 

We have gone sufficiently into detail on this very interesting 
subject for a work like the present, and refer the reader for ad- 
ditional facts to the books on medical jurisprudence, and also to 
the excellent Sand-Booh of Chemistry, by Abel and Bloxam, 
(1854, Philadelphia edit.) in which will be found a more extended 
view of the means for detecting the poison, and some new tests 
which we fear are too complex for practicing physicians. 

Arsenite of ammonia has been employed as a substitute for 
Fowler s solution, but it has no special claims. 



208 ARTEMISIA SANTONICA — MALE FERN. 

Artemisia Santonica. The Tartarian Southern-wood, or 
Wormseed. — The seeds are small, light, and oval, possessed of 
stomachic, emmenagogue, and anthelmintic properties. One to 
two drachms of the seeds may be taken twice a day by an 
adult. 

We notice it chiefly because of a non-azotized, crystalline 
body, obtained from the seeds, called santonin, which has been 
a good deal employed as an anthelmintic, and is said to be an im- 
portant item in some of the most popular nostrums for the cure 
of worms. 

Mr. Perry, of Droxford, England, has employed the santonin 
to expel the round and thread-worms that infest the intestinal 
canal. He gave three grains to a child two years old, followed 
in two hours by an aperient powder. The child voided thirty- 
seven worms on the next morning, some a foot long, and of the 
lumbricoid ascaris sort. Two children were treated in the same 
way, but in another family, and between forty and fifty worms 
came from each as soon. In a family of four children one hun- 
dred and twenty-four worms were voided at one time, and many 
more afterward, each child having taken but 6ne dose of the 
santonin. After the worms are expelled Mr. Perry gives a 
tonic mixture containing muriated tincture of iron and muriatic 
acid, changing the diet from a vegetable one to that of meat 
and bread. 

Santonin is a perfectly safe article, and is best given between 
bread and butter ; two hours after, a dose of calomel and jalap 
should be given. 

Asparagus. — As an article of food all are familiar with this 
vegetable, and none can be ignorant of the fact that it speedily 
gives its qualities to the blood, by the evidence furnished in the 
altered odor of the urine ; an odor which Franklin was the first 
to obviate by chewing a few tears of white turpentine. It is 
probable this well-known effect of asparagus led to its use as a 
diuretic. The medicinal power is obtained thus : — Take five 
ounces of dried tops of the plant, proof-spirit two pints, also 
five pounds of fresh tops of the plant ; bruise and press out the 
juice, evaporate at a low temperature to one pint, and strain ; 
then add a pint of rectified spirit. This is the Tinct. of Aspa- 
ragus. From half a drachm to two drachms of this tincture 
added to any ordinary diuretic that may not have acted well, is 
very sure to induce copious diuresis. — Association Medical 
Journal, May, 1855. 

Aspidium filix mas. Male Fern. — The roots and buds of 
this plant have been employed, time out of mind, for the destruc- 
tion of alimentary worms. More recently the oil of the fern 
has been preferred because of its smaller bulk ; and in several of 



ASSAFCETIDA. 209 

our best journals we notice high encomiums on its efficacy. Cases 
are cited in which all the usual appliances, and especially turpen- 
tine, have failed, but in which the oil of the male fern was suc- 
cessful. The ordinary adult dose is one drachm, followed in an 
hour by an ounce of castor oil. Such a dose caused the ejec- 
tion of a large tapeworm of great length. It escaped in about 
an hour after the castor oil was swallowed. This is a sample of 
the numerous cases to be found on record. 

Peschier, who introduced this remedy many years ago, says 
that a half-drachm of the oil or oleo-resin is equal to three 
drachms of the powdered root. He prepared it by digesting the 
largest buds of the plant in sulphuric ether, and the product was 
named by him the oleo-resin of male fern. He says this remedy 
was used in two hundred cases of tapeworm in Guy's Hospital, 
more than thirty years ago, with large success. Young children 
may take it safely. Half-drachm doses to children four years 
old will be quite proper ; for Dr. Gill gave it to a child two years 
old in doses of a drachm and a half. In about four or five 
hours after the first dose the worm is expelled ; but this result 
has sometimes come in one hour after the dose was swallowed. 

Theophrastus, Dioscorides, and Pliny, speak of the filix mas, 
or male fern, and its anthelmintic powers are of very ancient 
date. The plant grows in our own country, as well as in many 
parts of Europe, Asia, and Africa. 

Assafcetida. Ferula Assafoetida. Fetid Grum, or rather a 
fetid gum-resin. — Few articles of Materia Medica have a more 
ancient history than this, and it has been very highly esteemed 
for its medicinal powers. The tree is a native of Persia, the 
root being perennial and sending out every year fresh leaves 
from the cut stem, which is often more than two inches in thick- 
ness; the height of the tree varying from eight to ten feet. 
The thick stem, cut off near to the ground, pours out a copious 
milky juice, which gradually concretes and presents the gum- 
resin. The yield is said to be greatest and best when the trees 
are four years old. As we receive the gum-resin from abroad it 
is of various colors and contains more or less foreign matter; 
but the native juice is nearly colorless as it issues from the fresh- 
cut stem. 

In cold weather the fetid gum loses the adhesive and tenacious 
quality acquired by elevated temperature. In the one season it 
can be reduced to powder, and in the other it may be formed into 
pills with -very little effort by the thumb and fingers. 

The odor so characteristic of this drug is evolved by a volatile 
oil, which is lost by long or bad keeping. To preserve the article 
properly, glass-stoppered bottles should be used ; but as it is com- 



210 PROPERTIES OF FETID GUM. 

paratively cheap, the loss at any rate is trifling. Yet for medi- 
cinal purposes it should be kept as already advised. When lumps 
are broken, as they may be in cold weather, the inner surface 
presents various colors, as yellow, pink, white, red, while the 
exterior perhaps was an unmixed brown or yellow. 

As the article is not wholly a gum nor a resin, neither water 
nor alcohol will entirely dissolve it. Hot water takes up enough 
to make a decidedly medicinal preparation, to which the name 
of lac or milk of assafoetida has been given because of its milky 
appearance. Brandy or diluted alcohol will dissolve the whole, 
and thus we have a tincture of assafoetida. If to this tincture 
water be added, the whole becomes milky, because the predomi- 
nance of water effects the precipitation of the resinous portion. 
We can also dissolve a good deal of the gum-resin in strong 
vinegar, but the mixture is not much in use. 

The smell of this article is exceedingly odious to many per- 
sons, while some make no sort of objection to it and can even 
carry it about their persons. The Persians have employed it as 
a condiment from time immemorial. The Italians and Portu- 
guese eat it on beefsteak and in soups in preference to garlic 
and onions. The smell is, however, an obstacle to its medicinal 
administration in many instances. Some ladies feel almost in- 
sulted if the article is proposed for their benefit, because they 
think it implies an hysterical temperament, which, however real 
in their own persons, they are seldom willing to admit as apper- 
taining to them in anywise. Nevertheless, it is a good medicine, 
and often exactly suited to the hysteria and hypochondriac 
eccentricities of both sexes. 

In making an estimate of the therapeutic powers of assafoe- 
tida some have taken a pretty wide range. They have called it 
stimulant, antispasmodic, expectorant, cathartic, anthelmintic, 
emmenagogue. 

In regard to the stimulant power, I remark that it is very 
feeble, but that even though feeble it would seem to be im- 
proper in cases of high arterial excitement. The antispasmodic 
quality is relative. Spasm depends on different causes most ob- 
viously. If it proceed from excessive flatulence, as it often does, 
assafoetida will relieve by expelling the flatus. The expectorant 
action is also relative. If there be a strictured or spasmodic 
state of the bronchi, this medicine may relieve by subduing that 
state and enabling the patient to expectorate freely. The 
cathartic action is often witnessed when large doses are taken, 
and small ones very frequently and closely repeated. In such 
instances high irritation is sometimes set up in the rectum and 
verge of the anus. The anthelmintic and emmenagogue powers 



USES OF THE FETID GUM. 211 

are spoken of by some as though they were of frequent occur- 
rence. I regard them as accidental, and of little value. 

We have said that the gum can be made into pills very readily 
in warm weather. If the weather be cold, and the medicine be 
gently heated, pills can then be formed also without difficulty. 
From three to ten grains may be taken at a dose. 

The milk of assafoetida is easily prepared. In the absence of 
pestle and mortar, a lump of the size of a nutmeg may be put 
in a teacup half-full of hot water and gently broken down with 
a spoon. In a few minutes nearly the whole will be dissolved, 
making a milky-looking mixture. The medicine is improved by 
the addition of a tablespoon even full of powdered gum Arabic, 
and a little more hot water. Sugar also may be added, if de- 
sirable. The whole, after due trituration, may be placed in a 
bottle furnished with a good cork. The dose for an adult is a 
tablespoonful ; for a child, from a teaspoon half-full to three 
times that quantity, repeated frequently. 

The milk of assafoetida is a capital article for drunkards bent 
on reformation. It keeps up a desirable and salutary excite- 
ment in the stomach, calming nervous irritation of the whole 
system, and at length acting gently on the bowels. No fear 
need be entertained that too much will be taken. It is also a 
good medicine for curing the vile habit of opium-eating, and 
very soon performs well the office of a substitute. It is, I am 
very sure, vastly to be preferred in the diseases of young chil- 
dren to all kinds of opiate mixtures, which kill hundreds and 
thousands of the infantile part of society annually. All sorts 
of opiate doses gradually destroy the tone of the stomach and 
botvels,.perpetuate indigestion and costiveness, and render neces- 
sary acrid cathartics, which only augment the mischief The 
worst infantile colic is more certainly, speedily, and safely re- 
lieved by doses of the milk of assafoetida by the mouth, or by 
injections of the same, than by the best opiate in the world. 
These remarks are advanced with great confidence, because they 
are based on much experience in the management of young chil- 
dren. I have found an injection of the milk, as well as the dose 
by the mouth, to act like a charm, expelling flatus copiously, 
subduing spasms, and putting the child to sleep very promptly. 
In the absence of the milk the tincture of assafoetida will answer 
the same indications. 

In the treatment of influenza no medicine has pleased me so 
well as the milk of assafoetida, especially when old persons were 
the subjects. It removes the obstacle to free breathing, pro- 
motes expectoration, unloads the bronchial tubes, and allays 
general irritation. A tablespoonful may be given every one or 
two hours. In some cases of that disease a diarrhoea was super- 



212 ASTRINGENTS. 

added, as in the epidemic of 1828, near Philadelphia ; and in that 
emergency the following prescription was a favorite : — 

R. — Gum fetid, ^ij ; 

Powder of gum Arabic, 
White sugar, aa ^ss ; 
Sulph. morphia, gr. i ; 
Mint- water, ^viij. 
Rub the fetid gum with a little hot water till it is dissolved ; add the gum 
Arabic and sugar, then the mint-water and salt of morphia. Triturate the 
whole to make a perfect mixture. A tablespoonful is an adult dose. 

The simple milk of assafoetida without an opiate is well adapted 
to many cases of spasmodic asthma. It was Cullen's favorite, 
and called by him, from its effects in that disease, antispasmodic. 
In ordinary hooping-cough, and in purely spasmodic or non- 
membranous croup, the milk is often an excellent medicine, 
given alone or with an equal quantity of syrup of squills. 

Injections of assafoetida are highly praised by M. Ancelon in 
the treatment of the advanced stage of pertussis. For infants two 
years old three injections are ordered, each containing fifteen 
grains of the gum and two drops of Sydenham's liquid laudanum, 
in the smallest quantity of a vehicle, as flaxseed tea, that will 
answer. The. first is to be thrown up in the evening, the second 
on the next morning, and the third on the following night, say 
about twelve hours after the second. Associated with frictions 
of turpentine on soft flannel, this plan, it is said, will speedily 
arrest the disease. — N. Amer. Medico-Ghir. Rev., May, 1857. 

A plaster, made by triturating three or four drachms of the 
fetid gum with a drachm of camphor and whisky, or strong 
acetic acid, has been very serviceable as an application to the 
chest or between the shoulders. It is slightly counter-irritant, 
and protects the parts from the action of cold, removes stricture, 
and promotes expectoration. 

The fetid gum is supposed to act on the spinal nerves chiefly. 
Its successful operation by the rectum, as well as by the mouth, 
renders this more probable. If it evidently disturb the stomach 
or heart, or respiratory functions, it is likely there is organic 
disease of the brain or spinal marrow, and it should be discon- 
tinued. 

Astringents. — The term astringent is employed to denote 
the condensation or constriction of animal fibre by remedial 
agents, and on this ground they are supposed to act in re- 
straining hemorrhage. Much has been written to determine 
the precise action of this class of agents. Mere contraction 
of fibre is not decisive of the action of an astringent medicine, 
for galvanism and electricity cause violent contractions. And 
the action is often relative, too ; for while an unripe persimmon 
will constringe the mouth it will not at all affect the skin of 



ASTRINGENTS. 213 

the hand. Writers attempt to account for the operation of 
astringents on the living body by referring to the agency of such 
bodies in constringing dead matter ; and this is certainly plausible. 

Among the agents that seem to act as astringents on animal 
matter we name the following : cold, alcohol, acids, and tannin. 
Let us look at their action and see what light it can cast on the 
general operation of astringents on living matter. Cold is a 
negative something, the absence of a positive, viz., caloric ; the 
usual effect of which is to enlarge bodies, while its abstraction 
lessens. In other words, caloric tends to weaken the cohesive 
attraction between particles of matter, while cold strengthens 
that cohesion or makes the particles coalesce more firmly. On 
this principle a soft skin acquires firmness and strength ; and 
this is frequently exemplified in the living body. Excessive heat 
induces relaxation and debility, while cold weather braces the 
man and he feels invigorated. It is ascertained that a thong of 
untanned leather or skin which will bear a weight of ten 
pounds at 85° or 90°, will sustain a greater weight at 40°, 
which proves the condensing or cohesive effects of cold, or loss 
of temperature. We are aware that in dead matter an import- 
ant influence is absent, viz., vitality, which gives efficiency to 
astringents and makes their effects more permanent. As respects 
alcohol we find results not dissimilar. Dead flesh placed in 
alcohol is soon condensed or hardened, and hence this fluid is 
said to act as an astringent. I know that a chemical operation 
ensues, that water is absorbed and albumen coagulated, and that 
hence condensation results. But if alcohol be applied to the 
web of a frog's foot, the globules of the blood seem to stagnate 
and become compact in the vessels, so that vitality is suspended 
or destroyed. The long-continued use of alcohol internally con- 
denses, "hardens the stomach, so as to impair or destroy its sensi- 
bility. It becomes thick, hard, callous to impressions, so that 
the most energetic stimulus fails to affect it. Such is its condi- 
tion in the delirium tremens of old drunkards. Acids also con- 
stringe dead animal matter, condensing and making it more firm 
by coagulating the albumen and forming new compounds. Some 
deny that they act thus on the human body, but I see no reason 
why they may not gradually develop the same results there, 
though to a less obvious extent. We err in our judgment some- 
times by overlooking the difference of sensibility in different 
structures. An acid may constringe the mouth and not affect 
the stomach at all. Even the acrid semi-mature persimmon 
evinces this diversity. 

All vegetable matters that contain tannin have a constringing 
power more or less manifest. In their action on dead animal 
matter we have the clearest proof of this agency in the formation 



214 PREPARATIONS OF GOLD. 

of leather. In such cases the tannin combines with the gelatine 
of the dead matter, forming a solid insoluble compound, which 
resists the action of water and does not become putrid. Some- 
thing analogous flows from the action of tannin on the living 
body, as is seen by mixing catechu and other astringents with 
fresh-drawn blood, coagulation being much more speedily induced 
than if astringents were not present. If catechu be injected 
into the veins of a dog, the blood is found coagulated in the 
heart and large vessels. These facts render it probable that 
astringents act on the living body very much as they do on dead 
matter. Yet we do not affirm that the action in both cases is 
precisely alike. We know, indeed, that some things called astrin- 
gents display the constringing power, in virtue of a super- 
added quality, in part at least. Sugar of lead has far less obvious 
astringency than alum or persimmon, and yet it is decidedly 
superior for the arrest of hemorrhages. 

It may be affirmed, as a general principle, that astringents 
operate as excitants or stimulants, yet we must always dis- 
tinguish between astringents and stimulants and tonics, though 
some one article may seem to possess all these properties. 

The agency of astringents in arresting hemorrhage cannot 
always be explained apart from their passage into the blood and 
on to the points of leison. In a frightful bleeding from the 
prostate gland large doses of Ruspini's styptic succeeded after 
all other means failed. The styptic was repeated twice, and the 
bleeding ceased entirely in half an hour. In like manner a few 
grains of sugar of lead have often put a stop to an alarming 
hemorrhage. In such cases, whatever may be due to the action 
on the nervous system, there can be no doubt that a salutary 
impression is made on the blood and blood-vessels. 

In all true profluvia astringents are no doubt proper, except- 
ing in those cases in which there is high arterial excitement and 
over fullness of the vessels. The previous use of the lancet or 
local depletion is obviously demanded by such a condition, which 
will frequently arrest the discharge and render astringents un- 
necessary. This distinction should ever be borne in mind. 

Atropa Belladonna. (See Belladonna.) 

Aurum. Grold. — The preparations of gold were introduced 
originally as substitutes for mercurials in the treatment of 
syphilis, in the belief that they would be equally efficacious 
and yet avoid the unpleasant salivation induced by mercury. 
They are all highly poisonous, and hence the dose has always 
been very minute. The best, because the safest and the most 
easily taken, is the ethereal or potable gold, made by shaking a 
very strong watery solution of chloride of gold with an equal 
bulk of pure sulphuric ether. The ethereal solution collects on 



PREPARATIONS OP GOLD. 215 

the surface, while a heavier fixed liquid remains below. The 
lighter liquid is to be decanted and kept in opaque glass bottles, 
to guard against the action of light. 

The chloride or muriate of gold is made by digesting frag- 
ments of gold in nitro-muriatic acid and evaporating to dryness 
with a gentle heat so as to drive off all excess of acid. The 
dose is from one-sixteenth to one-eighth of a grain in pill. 

The chloride of gold and soda has been highly spoken of by 
the French. To make it, dissolve ninety-six grains of pure gold 
in nitro-muriatic acid, evaporate and crystallize. Then dissolve 
the crystals of gold so made in pure water, and add thirty grains 
of dried muriate of soda; evaporate and crystallize as before. 
The resulting compound is a double chloride, which, being quite 
deliquescent, should be kept in tight bottles of glass. It is 
employed in Paris and London thus : — 

]£. — Chloride of gold and soda, gr. j ; 
White sugar, gss. 
Mix, to make twelve powders, one of which to be taken twice or thrice a day. 

The better plan is to put the powder on the tongue and rub it 
against the roof of the mouth until quite dissolved. Some dis- 
coloration takes place, but it soon disappears. Chancres are 
reported as yielding to this medicine in from eight to twelve 
days without any sort of local application. In the New York 
Medical Repository, vol. iv., new series, Dr. Delafield has given 
the result of its use in eighty-one cases of syphilis, and his 
report is favorable. He gave the medicine in pills containing 
one-sixteenth of a grain, and he rubbed into the gums from one- 
eighth to one-fourth of a grain, mixed with powder of liquorice- 
root, daily. Dr. Wendt, in Bust's Magazine, tells of eighteen 
cases of dropsy, consequential on intermittents, treated with the 
same medicine ; of the number, seven were cured. 

Hypertrophy of the tongue has been successfully treated by 
the same preparation. One-fifth of a grain was given in milk 
for a dose, and the tongue rubbed with a grain mixed with 5ss 
of lard. In a few days the tongue regained its natural size and 
appearance. 

In Rust's Magazine we have an account of its exhibition by 
Dr. Jahn, of Menningen, in diseases of the eye. He particular- 
izes impetiginous, scrofulous, gouty, rheumatic, and simple 
chronic inflammations, and also the purulent ophthalmia of in- 
fants. His usual mixture consisted of two grains dissolved in 
six ounces of pure water. A few drops were placed between 
the eyelids, and linen compresses moistened with the same laid 
over the eye. The practice is said to have been successful. 
This local treatment is hardly ever proper apart from the use of 



216 AUSCULTATION. 

remedies to correct constitutional disorder, especially as found 
in the stomach and bowels. 

A strong solution of the chloride of gold is escharotie. For 
this purpose dissolve six grains in a drachm of nitro-muriatic 
acid and apply the solution on lint to the sore. The applica- 
tion is not painful. 

Auscultation. — This is not, in the common acceptation, an 
article of Materia Medica, but it is so closely interwoven with a 
wise system of Therapeutics as to claim the attention of all prac- 
titioners who expect to make accurate diagnoses in obscure cases. 
We do not hold to the omnipotence of this aid, as some seem to 
have done, and yet we are sure that some doubtful forms of dis- 
ease can be more certainly defined by its help than by any other 
mode of research. Hundreds of blunders have been perpetrated 
by physicians, in points of judgment and practice, that might 
have been avoided by a little attention to this point. We name, 
by way of illustration, hydrothorax, the rational symptoms of 
which are not decisive proofs of its actual presence. If, how- 
ever, we detect the special physical signs of that disease, we are 
no longer in doubt. Many persons have been treated for hydro- 
thorax who never labored under that malady, and the error 
might have been averted by the timely aid of auscultation. 

It does not matter whether we employ the naked ear or a 
stethoscope in exploring the chest or abdomen. Auscultation 
is the exploration by the ear in some way or other of the cavity 
or organ under inspection; and every case must determine 
whether the investigation shall be by mediate or immediate 
auscultation. The intention is to compare the actual sounds of 
the lungs or heart, or contents of the abdomen, with the natural 
and healthful sounds, and this comparison must necessarily be 
the result of careful observation in order to be accurate and of 
any practical value. 

Percussion, which is usually made with the ends of two or 
three fingers on the chest or elsewhere, gives its monitions on 
the same general principles, and is essentially of the nature of 
auscultation. This, as well as the stethoscope, or even the use 
of the ear alone, will necessarily call for perfection in the organ 
of hearing. A deaf man, or one whose hearing is even dull, can 
derive no assistance from this means of investigation, and is 
compelled to base his judgment on the symptoms alone. 

We feel it to be our duty to urge upon the young members of 
the profession the importance of much study of this subject. It 
will fill up many an otherwise vacant hour very profitably and 
pleasantly, while it will insure to them a valuable auxiliary in 
their future practical duties. They will never see the day when 
such an appropriation of leisure time will be regretted. They 



OATMEAL GRUEL — BALSAM. 217 

may, as they grow in years, feel competent to decide on the 
evidence of symptoms only in most cases, yet now and then they 
will be compelled to test the powers of auscultation in doubtful 
cases, if competent to do so by previous study. 

I know of nothing more satisfactory in the nature of diagnosis 
than the determination of the question of doubtful pregnancy. 
Many cases of this kind are invested with peculiar delicacy and 
call for great circumspection. The common signs of pregnancy 
may deceive, for various reasons that need not now be detailed. 
It may be impracticable to make a per vaginam examination. 
The abdomen is very large, and the lady protests that she is 
dropsical, and that pregnancy is an impossibility. Now, under 
such a state of doubt and uncertainty, the physician is called 
upon to give his opinion. If by any sort of stratagem he can 
be permitted to apply a stethoscope over the abdomen in several 
spots, covered by a sheet so as to avoid exposure, the mystery 
may be cleared up in a few minutes. If two sets of pulsations 
be detected, the one with sixty in a minute, the other with one 
hundred and thirty or one hundred and forty, the nature of the 
dropsy is disclosed, and the fact of pregnancy established. The 
natural pulsations of the mother's system and those of the foetus 
in utero are infallible guides. 

In a work like the present we cannot enter into details on the 
subject of auscultation. The reader will do well to consult the 
small work of Barth and Roget, which will give all needful in- 
formation and abundantly qualify any intelligent man for this 
important part of professional duty. 

Aven^i Farina. Oatmeal. — This is the basis of the best kind 
of gruel for invalids. It is a safe, pleasant, and sufficiently 
nutritive diet. To make it aright, the best article should be 
selected, the freshest and sweetest. A tablespoonful or two will 
make nearly a quart of gruel. Before boiling, the meal should 
be well rubbed with enough water to make a paste, so as to get 
rid of lumps. Then add the balance of the water and boil from 
ten to fifteen minutes, stirring frequently. A new, clean earthen 
vessel is preferable in preparing this article. Sugar and spice 
may be added, as may be agreeable. 

This gruel is a good vehicle for administering medicine by the 
mouth, or by injection. To induce free and continued purging, 
add a half-ounce of Epsom salt to a quart of thin gruel and give 
a wineglassful every hour or two through the day. A decidedly 
sedative result will soon be obvious. 

Bacc^i Juniperi. (See Juniper Berries.) 

Balsam. — We introduce this term to give the proper explana- 
tion, and for little more. It means any vegetable juice, liquid, 

15 



218 PREPARATIONS OF BALSAM TOLTT. 

or otherwise, of a resinous nature, and containing more or less 
benzoic acid. The article copaiba, so often called balsam copaiba, 
does not contain benzoic acid, and is therefore not to be regarded 
as a balsam. Much of the unblushing quackery of the present 
day is emblazoned under the pompous name of Somebody's balsam, 
who perhaps never lived, or never heard of such a medley in his 
lifetime. Very few articles really entitled to the name of balsam 
have ever been known to the regular medical profession. We 
shall notice only one. 

Balsam Tolu. Tolu Balsam. — The myroxylon Peruiferum, 
which yields the Peruvian balsam, is said also to yield also the 
Tolu balsam. Incisions made into the bark of the tree cause 
the juice to flow freely, and this, collected in mats, soon hardens 
and takes on a dark-brown color. In cold weather this balsam 
is quite brittle and may be pulverized. In warm weather it is 
soft, very tenacious, and adhesive. The odor is peculiarly grate- 
ful, though when burnt it emits a strong, disagreeable smell. 
Distilled with water it yields volatile oil and benzoic acid. Alco- 
hol dissolves it entirely ; but not a particle can be taken up even 
by boiling water, which, however, is strongly impregnated with 
the balsamic odor. 

The balsam, tincture, and syrup are all possessed of expecto- 
rant qualities, and are usually called stimulant expectorants. 
In dry, chronic coughs, with no inflammatory action, twenty 
grains of the balsam may be given three times a day in pill, or 
in emulsion made with gum Arabic, or yolk of egg. A tea- 
spoonful of the tincture is an adult dose, and may be repeated 
according to the urgency of the cough. This tincture is the 
basis of HilVs balsam of honey, which the common people used 
to gaze at as though it were enchanted, because mixture with 
water rendered the whole of a pure milk white. This change 
is a necessary effect of the addition of water to a resinous 
tincture. Two or three ounces of balsam Tolu and a quart of 
alcohol make a good tincture. 

The compound tincture of benzoin, called sometimes Friar s 
balsam, contains balsam Tolu, and has long been esteemed a good 
application to wounds and ulcers. 

The syrup of Tolu is made by boiling an ounce of the balsam 
in pure water and straining the mixture. A quart of water is 
usually employed, and it is impregnated with the odor of the 
balsam. To the liquor add two pounds of refined sugar, and 
simmer for fifteen minutes over a gentle fire. The dose is a 
tablespoonful often repeated. The syrup is also made by adding 
an ounce of the tincture to a pint of simple syrup. 

The late Dr. Rush was very partial to a mixture of digitalis, 



BATHING — ITS USES IN DISEASE. 219 

Tolu, and opium, in the coughs of old persons. The proportions 
were as follows : — 

R.— Tinct. digital. 

opii, aa ^i ; 

Tolu, !§i. 

Mix. The dose is a teaspoonful at bedtime in a little water, and occasionally 
through the day. 

Turlington 's balsam and Hill's balsam of honey were formerly 
regarded as among the very best medicines for the relief of 
severe colds. Both contain the balsam of Tolu in considerable 
quantities, as will be seen from the formulae subjoined : — 

Turlington s Balsam. 

£ R. — Gum benzoin, ^xviij ; 

Storax, liq. 5viij ; 
Bals. Tolu, |yi ; 

Peru, :|ij ; 

Pulv. aloes, 5 iv ; 

elemi, Jfiij ; 

Alcohol cong. Ibij. 
Add enough liquorice ball to give a dark color, and digest for ten days 

HilVs Balsam of Honey. 

R . — Gum opii, £i ; 
Bals. Tolu, gij ; 
Flor. benzoin, ^ij ; 
Mellis opt. ^iss ; 
Alcohol, R)L 
Mix, and digest for a week or ten days. 

Water added to a teaspoonful of either of these mixtures 
changes it into a. milky liquid, and much of the supposed virtue 
of the medicine depends on this wonderful change. 

Bark, Peruvian. (See Cinchona.) 

Bathing. — This is a very copious theme, and vastly important 
to society. We have long felt that medical men were too reluc- 
tant to advise on this point, especially in reference to the 
young. And therefore we introduce our remarks by referring 
to bathing as practiced by the youth everywhere, in the hottest 
weather ; going into the water half a dozen times a day, with a 
burning sun pouring his intensest rays on the unprotected head. 
Very much of the indisposition of young persons is induced by 
this very hurtful habit. To bathe every day, either early in the 
morning or late in the afternoon, will rarely injure any one, 
provided a single bath will satisfy. More than this cannot be 
necessary, and may do harm. 

To men of business, harrassed and perplexed not only by 
pecuniary troubles but by the heat and dirt of a city, a bath at 



220 ACTION OF WATER ON THE SKIN. 

night in water from 85° to 100° is very refreshing. From ten 
to fifteen minutes will suffice for this operation, which cleanses 
the surface and promotes a healthful equilibrium of all the 
organs. 

In all febrile diseases tending to cerebral congestion, with 
pain and heat of the head, and especially after bleeding, pro- 
vided arterial excitement be great, cold bathing to the scalp will 
prove very salutary and grateful. Ice in bladders to the head, 
and a hot foot-bath at the same time, will often give speedy 
relief. In chorea, tetanus, and hysteria, the cold-bath and the 
shower-bath are frequently of great value. 

Many skin diseases are more certainly relieved by warm than 
by cold bathing. Water applied quite hot will frequently allay 
the most terrible pruritus, and the patient will soon fall asleep. 
In regard to local applications, as to the eye, the question of hot 
or cold must in some measure be regulated and decided by indi- 
vidual peculiarity or idiosyncrasy. 

It has occurred to me that nothing better can be presented in 
the further notice of this subject than the following quotations 
from the work on diet and regimen by Dr. Robertson. The 
statements of the writer seem to be in close agreement with the 
dictates of common sense and the generally received principles 
of medical philosophy : — 

" On the propriety of regular and frequent ablution as a means 
of cleanliness it is needless to enter fully. But a brief con- 
sideration of the physiological effects of water, whether applied 
to the surface of the body or taken into the stomaeh, may be 
useful. 

"It will be necessary to premise my observations on the effects 
of water applied to the surface by some short account of the 
skin itself. 

" The skin is to be regarded not only as a covering to the 
body, as a protection to the softer and more delicate and more 
sensitive structures placed beneath it, but as being also intended 
to subserve many other offices no less important, although some 
of these offices will possibly be now first made known to the 
reader. The skin is constantly performing the necessary func- 
tion of expelling a considerable portion of the residue of nutrition 
and digestion. 'To man,' says Bichat, ' it is a sensitive limit 
placed on the boundaries of his soul, with which limit exterior 
forms incessantly come in contact to establish the connections of 
his animal life and thus bind his existence with that of all that 
surrounds him.'* Eminently a bad conductor of heat, it main- 
tains the elevated temperature of the body by confining its heat, 

* Bichat's "General Anatomy." 



ACTION ON THE SKIN. 221 

and prevents external heat and external cold from necessarily 
and at once destroying life. Protected by this power of resist- 
ing the passage of heat, life continues under the severest cold, 
and is able to endure with comparatively little inconvenience 
almost incredible elevations of temperature. Supplied with an 
enormous amount of nervous filaments to endow it with sensa- 
tion, it not only acts as a sentinel against danger ? as the mind's 
ready and most accurate informant on all points connected with 
external things, but it is a ready means by which the mind may 
be made to endure extreme suffering and the sensorial functions 
be materially and directly injured. It is a ready means by which 
the nervous system may be soothed, quietude and tranquil feel- 
ings brought back, and even cheerfulness and mental acuteness 
substituted for melancholy and mental torpor. Furnished with 
a vast amount of blood to supply to its own substance constant re- 
newal, to supply its secreting organs, and to keep up the energy 
and healthiness of the nerves which are dependent on the supply 
of blood, the skin is to be looked upon as an important organ, 
by influencing which a very large quantity of blood may be 
suddenly thrown into the system, and there, in an incredibly 
short time, produce perhaps irreparable injury ; as an organ, by 
attracting the blood, to which the internal organs may be relieved 
at once from a load of blood and enabled to resume the perform- 
ance of those natural and necessary functions which it is their 
business to discharge and which that gorging of the vessels had 
interrupted. When it is considered that probably the extent of 
the skin in a man of ordinary size is not less than 2500 square 
inches,* we can scarcely wonder at any, however extravagant, 
estimate of the quantity of blood which it always, when healthy, 
contains ; we can scarcely feel surprised if we are told that 
it contains more nervous matter than that which forms the brain 
or the spinal marrow. 

" The skin, properly so called, is covered by a much thinner 
layer, called the cuticle, a layer which may with little impropriety 
be called inorganic ; a structure which is destitute of nerves or 
blood-vessels, without feeling or sensation of any kind, and in 
fact without life. This structure is then intermediate between 
the body and external objects ; it protects it from being irritated 
by contact with those objects without preventing it from feeling 
them. This is not renewed in the way that other parts of the 
body are, by absorption of the old and deposition of new par- 
ticles, but by a constant deposition of small scales or powder, 
the particles of which adhering to the subjacent surface and to 
each other constitute the cuticle. By friction these are partly 

* "The Principles of Physiology," &c. By Andrew Combe, M.I). 



222 ACTION ON THE SKIN. 

rubbed off, likewise by ablution. If neither rubbed nor washed, 
the deposition going on, these scales or particles accumulate and 
form a thick crust on the outer side of the cuticle, a fact of which 
any person who has neglected to wash his feet may readily satisfy 
himself. 

" Under the cuticle, between it and the skin, is situated what 
is sometimes, but as it would seem erroneously, called a coat or 
layer, the rete mucosum, a net-work of vessels of excessive 
minuteness : a net-work which, according to Bichat, consists of 
two distinct sets of vessels ; the one containing colorless fluids, 
which set supplies the exhalants, and consequently produces the 
perspiration ; which, although usually filled with colorless fluids, 
may, by excitement of the heart's action, by exercise, or emotions, 
or passions, or by exciting the vascular action of the part by friction, 
be filled with red particles, with blood, as after running, as in blush- 
ing, &c. ; and another set in which there is always a languid 
circulation of fluids, those fluids being of different colors in the 
different races of men, — black in the negro, white in the European, 
&c. Well, this delicate net-work, whose important effects I shall 
presently have to enlarge upon, is penetrated by papillae, which 
come into contact with the cuticle and are the seat of touch — 
these papillae arising from the skin — which, a highly vascular and 
nervous structure, flexible, elastic, and contractile, is loosely con- 
nected to the subjacent textures by cellular tissue ; the interstices 
between those textures being more or less filled up with 
fatty matters, give roundness and smoothness and contour to 
the form. 

" After this brief but perhaps sufficient notice of the structure 
and functions of the skin, I shall shortly notice the effect which 
temperature produces upon it. 

" Warmth at first increases the action of the vessels of the 
skin, causing a more considerable efflux of perspirable matter ; the 
skin is sensibly reddened ; and if the heat is increased still fur- 
ther, inflammation, blistering, contraction, wrinkling of the tissue, 
and blackening with disorganization ensue. 

" Cold at first stimulates the skin, reddening it ; continued, the 
vessels contract, the rete mucosum no longer circulates its fluid, 
perspiration is no longer evolved, the skin becomes pale, and if 
the cold is increased in intensity loss of feeling and death of the 
part, if not of the individual, ensues. 

" This supposes that the individual does not change his me- 
dium — that the skin is still surrounded with air. The effect of 
water is somewhat different. If the body is in a state of vigor 
and in full possession of its heat, the skin being unchilled, the 
effect of immersion in warm water is much the same as that from 
moderate heat applied, in other ways, except that the breathing 



CAUTIONS IN THE USE OF COLD BATHING. 223 

is somewhat more laborious and that the skin more actively 
pours out its secretions. The effect of immersion in cold water 
under the same circumstances is at first a rapid chilling, varying 
in degree according to the powers of the system, the fullness or 
emptiness of the stomach, the previous heat of the body, and the 
temperature of the water. This, if all things are favorable, is 
speedily followed by a brisk reaction, the body rapidly regaining 
its temperature ; and if now the person leaves the bath, before 
the heat has once again begun to diminish, and has his surface 
instantly protected w T ith clothing, the consequent effects are a 
much-increased action of the vessels of the skin, and a relative 
increase of the amount of its secretions, and a relative increase 
of its temperature. 

" This does not, however, include the whole difference between 
the effects of hot water and those of cold. The cold water not 
only clears the surface of its scurf and of its unctuosity as 
thoroughly as the hot water does, but it has this further effect, 
the vascular excitement into which the hot water throws the 
skin, and especially the rete mucosum, is readily and easily 
checked by cold air, or any depressing influence, acting either 
on the heart's action or on the skin itself; whereas, the vascular 
excitement into which cold water throws these textures is rather 
increased by cold air, is less liable to be materially or suddenly 
lessened by any depressing influence. 

"I have said that the first effect of cold water on the skin 
is that of rapidly chilling it. Cold water acts on its vascular 
system as a direct sedative, checking its circulation and stopping 
its secretions, and throwing a large quantity of blood on the in- 
ternal organs. If the water is not extraordinarily cold and the 
powers of the heart and arteries are in full vigor, they are roused 
by this sudden rush of blood into extraordinary exertion, and, 
driving the blood back again to the skin, cause the circulation 
to be resumed with even unwonted briskness ; the warmth of the 
surface is restored, and reaction has taken place. This state of 
things will continue a longer or shorter time, according to cir- 
cumstances, and then the heart and the arteries become no 
longer able to counteract the cooling effects of the cold water ; 
they are overpowered, and, no longer able to dispose of the 
quantity of blood which the rapidly refrigerating powers of the 
water are constantly throwing back upon them, they become 
loaded with blood ; their action becomes oppressed and less 
energetic ; the skin is now once more chilled,, its circulation is 
once again languid; shivering, loss of feeling, stupor, and, the 
cause still continuing, death ensues. 

"I have said above that in order to the heart and arteries 
being able to repel the blood again to the skin, which the im- 



224 CAUTIONS IN THE USE OF COLD BATHING. 

mersion in cold water had thrown upon them, several conditions 
are necessary. I will now glance rapidly at each of these. 

"1st. The water should not be extraordinarily cold: this must 
vary according to the circumstances presently to be mentioned ; 
but, generally speaking, the temperature of the water should not 
be lower than sixty degrees. The heat of the body being gene- 
rally about ninety-six degrees, a bath, even at the temperature 
of eighty degrees, will usually at first feel somewhat cold to the 
bather. But it must not be forgotten that, provided speedy re- 
action does come on, and provided there is no organ or function 
in such a state as to be injured by the influx of blood, the colder 
the water, within certain bounds, the greater and more genial, 
and more beneficial, will be the reaction. 

" 2d. As to the length of time a person should remain immersed. 
The colder the water the shorter time should the immersion con- 
tinue. It is seldom prudent to remain longer in a cold bath than 
ten or fifteen minutes. The invalid should hardly continue in it 
so long as that. 

" 3d. The effect will vary according to the degree of energy 
with which the heart and arteries are acting at the time. There 
cannot be a more dangerous nor more imprudent practice than 
cold bathing while the body is fatigued, no matter how, whether 
from excessive muscular action, or from heat ; whether it be the 
consequence of high mental excitement, or of long-continued 
mental exertion, or loss of sleep, or however else brought about. 
The heart and arteries acting languidly — the cutaneous circula- 
tion being therefore feeble, it requires very little cold, or other 
depressing cause, to load unduly the heart and arteries, having 
already almost more to do than they can perform without incon- 
venience ; and in this case there is either no reaction or the 
reaction is only partial. Long-continued shiverings, great pros- 
tration of strength succeed, followed perhaps by local determina- 
tions of blood, or by a generally disordered state of the system, 
inflammatory affections, &c. I will illustrate this by the often- 
quoted case of the late Dr. Currie, as recorded by himself in his 
wonder-working book, the Medical Reports. The case will most 
probably be unknown to the reader. 

" 'On the first of September, 1778, two students of medicine 
at Edinburgh set out on foot on a journey, a considerable part of 
which lay along one of the rivers of Scotland.* They started 
by sunrise, and proceeded with alacrity in the cool of the morn- 
ing. At the end of eight miles they breakfasted, rested for an 
hour, and then resumed their journey. The day grew warm as 
it advanced, and after a march of eight miles more they arrived, 

* The Tweed. The journey was from Edinburgh to Moffat. 



EFFECTS OF COLD BATHING. 225 

heated but not fatigued, on the banks of the river above-men- 
tioned about eleven in the forenoon. Urged by the fervor of 
the day and tempted by the beauty of the stream,- they stripped 
instantly and threw themselves into the river. The utmost 
refreshment followed ; and when they retired to the neighboring 
inn this was succeeded by a disposition to sleep, which they in- 
dulged. In the afternoon they proceeded, and traveling sixteen 
miles farther at a single stretch, arrived at the inn, where they 
were to sleep, a little after sunset. The afternoon had been 
warm and they perspired profusely ; but the evening was tempe- 
rate and rather cool. They had traveled for some miles slowly, 
and arrived at the end of their journey stiffened and wearied 
with their exercise. 

" 'The refreshment which they had experienced in the morn- 
ing from bathing, however, induced one of them to repeat the 
experiment, and he went perfectly cool into the same river, 
expecting to relax his limbs in the water and afterward to 
enjoy profound sleep. The consequences were very different. 
The Tweed, which was so refreshing in the morning, now felt 
extremely cold, and he left the water hastily. No genial glow 
succeeded, but a feverish chill remained for some time, with 
small, frequent pulse, and flying pains over the body. Warm 
liquids and frictions brought on at length considerable heat, and 
toward morning perspiration and sleep followed. Next day 
about noon they proceeded on foot, but the traveler who had 
bathed was extremely feeble ; and though they had to perform a 
journey of a single stage only, as some part of it was difficult 
and mountainous, he was obliged to take the assistance of a car- 
riage which overtook them on the road. It was several days 
before he recovered his usual vigor. This relation will not, I 
hope, be deemed of the less authority because it is given by the 
person who suffered by his imprudence.' 

"4th. The effect of immersion in cold water will vary accord- 
ing to the heat of the skin, to the vigor with which the cuta- 
neous circulation is going on at the time. The hotter the skin 
the greater the vigor of the circulation, the more safe is cold 
bathing. But it must be especially remarked that this supposes 
the heat to be caused not merely by the sun's rays, or any simi- 
lar external heating cause, but to be partially produced, and 
such as might be almost accounted for, by the energetic action of 
the heart and arteries. In fact, the hotter the surface of the 
body under such circumstances the quicker the reaction. It is, 
therefore, not well to stand any long time after undressing 
before plunging into the water.* Such a practice chills the 

* Currie's "Medical Reports." 



226 ACTION OF THE COLD BATH. 

body very much more, and in many cases renders bathing, 
which would be otherwise profitable and advantageous, abso- 
lutely unsafe. 

" 5th. The effect of immersion in cold water will vary accord- 
ing to the fullness or emptiness of the stomach ; according to the 
period of digestion ; according to the facility of digestion. It 
has been remarked elsewhere that the stomach during digestion, 
and particularly during the first stages of digestion, is supplied 
with a very large quantity of blood. Bearing this in mind, let 
the reader think of what must necessarily be the effect of either 
warm or cold bathing while the stomach is in that state ; and 
more especially if the quantity of blood sent to the stomach is 
barely sufficient for the purpose of digestion ; more particularly if 
the action of the stomach is weak or disordered. The quantity 
of blood either directly or remotely directed to the skin by either 
warm or cold bathing would lead the reader naturally to precon- 
ceive that a more or less severe fit of indigestion would follow. 
But this is not the only risk which attends the practice of cold 
bathing under such circumstances: so large a quantity of blood 
being directed to the stomach the whole energies of the heart and 
arteries are not at immediate command ; the skin is chilled, and 
the blood thrown on the great vessels ; these are unprepared to 
devote all their powers to the restoration of the circulation in the 
skin ; diverted by the demands of the stomach and those of the 
skin, both duties are but partially performed, unless the powers 
of the system are very great and quite unimpaired ; and not only 
are the functions of the stomach interrupted, but reaction is not 
immediate, and much risk is run of causing a disordered con- 
dition of the whole vascular system and local and perhaps serious 
disease. 

"6th. The effect of immersion in cold water will vary accord- 
ing to the state of the mind. The influence of the mind on all 
the functions of the body, and particularly on the heart, are 
well known to be great. The palpitation which attends excite- 
ment of the mind ; the blush which accompanies a sense of shame ; 
the pallor of the skin, and shiverings which attend fear ; the local 
determinations of blood, as apoplexy, &c, which so often follow 
violent passions or severe mental exercise, are all demonstrations 
of this fact. If the mind is languid, debilitated, worn out, leth- 
argic, desponding, the bodily functions are almost always disor- 
dered in their action, and the use of the cold bath will most 
commonly be attended with risk ; it will not be followed by 
instantaneous and necessary reaction. The hot bath, in cases of 
this kind, by determining a large quantity of blood to the skin, 
and so relieving the brain and the greater masses of the nervous 
system from a large amount of blood, is to be preferred in many 



SHAMPOOING. 227 

such cases, and, as a means of temporary relief, is, in many of 
them, infinitely better than the major part of the remedies to 
which the student and the melancholic too commonly fly. 

"Of the value of muscular exercise and friction of the skin 
while the person is bathing too much can hardly be said. 
Swimming calls into action almost every muscle of the body, 
and hence it is valuable as a kind of exercise ; but when it is 
considered how much this must assist the heart and arteries in 
circulating the blood, and so lessening the risk of irregular distri- 
bution — internal congestion — of the blood, or of unduly diminish- 
ing the circulation of the blood in the vessels of the skin, and, 
by thus equalizing the distribution of the blood, how efficient 
must be its action in preventing depression of the vital powers, 
its value will be more fully appreciated. In the ordinary baths, 
however, swimming is impossible, and its place should, as far as 
possible, be supplied by constant, and, if not specially contra- 
indicated, even violent exercise of the muscles of the trunk and 
extremities, while the individual remains in the water. In the 
warm bath even this can hardly be done, and frictions, and the 
nearest imitation of that important remedial measure, shampoo- 
ing, should be made use of. A vigorous use of the flesh-brush, 
and kneading the muscles well with the fingers, will commonly 
be found to be useful adjuncts to the warm bath. 

"A description of what shampooing is will, perhaps, better 
enable the reader to imitate the process. Such an imitation will 
not be comparable to what shampooing is when scientifically 
performed by a second person; yet it will not be valueless. The 
following, decidedly the best that I have met with, is taken 
from a treatise on the vapor-bath, 'By F. Gilney, M.D., 
London, 1824.' It is after the use of the vapor-bath that the 
practice is most commonly had recourse to. 

" 'After exposure to the bath, while the body is yet warm from 
the effects of the vapor, the shampooman proceeds, according 
to the circumstances of the case, from gentle friction, gradually 
increased to pressure, along the fleshy and tendinous parts of 
the limb ; he kneads and grasps the muscle repeatedly, presses 
with the points of his fingers along its course, and then follows 
friction in a greater or less degree, alternating one with the 
other, while the hand is smeared with a medicated oil in the 
specific influence of which the operator has considerable confi- 
dence. This process is continued for a shorter or longer space 
of time, and, according to circumstances, is either succeeded or 
preceded by an extension of the capsular ligament of each joint, 
from the larger to the smaller, causing each to crack so as to 
be distinctly heard ; which also succeeds from the process being 
extended to each connecting ligament of the vertebrae of the 



228 USE OF THE WARM BATH. 

back and loins. The sensation at the moment is far from 
agreeable, but is succeeded by effects not dissimilar to what 
arises from brisk electrical sparks taken from the joints in quick 
succession. 

"'This operation upon the articulations of the limbs is much 
less frequently repeated than the other parts of the process of 
shampooing, and in its effects on disease must be considered as 
generally unnecessary and often mischievous; but this should 
not be said of friction, from which, by ancient usage as well as 
modern experience, we are instructed how much can be derived 
when practiced with judgment and patient perseverance.' 

"Many persons, it is well known, are much benefited by an 
occasional use of the warm bath just before getting into bed at 
night, and the practice is not, under these circumstances, fol- 
lowed by any inconvenience ; but if they use the warm bath at 
any other time, it is followed by a sense of dullness, and is not 
unattended with danger. This is attributable to two distinct 
but co-operating causes. 1st. The oleaginous secretion that is 
on the surface of the skin is removed by the bath. 2d. The 
cutaneous vessels are much excited by the heat of the water, 
and that excitement is often followed, especially if the system 
be weak, by corresponding exhaustion and depression, and during 
that state the circulation of the blood in the skin is easily checked 
by contact with the cold air ; the blood is thus thrown upon the 
internal organs, and congestive or inflammatory disorders of 
those organs often ensue. It is then well, under such, and in- 
deed under all ordinary circumstances, to use the hot bath at 
bedtime in preference to using it at any other period; for the 
bed and bed-clothes defend the surface from the cold air until 
the oleaginous secretion has again been poured out, and until 
the excitement that the heat has produced has gone off, and the 
corresponding and resulting depression has likewise departed, 
and a natural and proper degree of vigor and activity of the 
cutaneous circulation has returned. 

"I have hitherto only considered the effects of total immersion 
in pure water. These effects may be and are considerably 
varied by additions to the water of salines, &c. ; by only part 
of the body being immersed ; and by the water being merely 
applied to the body, either poured over it or the body being 
' sponged with it. 

"1st. The effect which the addition of salt to the water pro- 
duces is very decided, probably by its stimulating effects by 
irritating the skin; but at all events, in some way or other, it 
assists the reaction. In other words, a system which would be 
depressed by immersion in merely cold water, in which reaction 
would not come on after such a bath, would be only momentarily 






VARIOUS MODES OF BATHING. 229 

depressed by immersion in salt and water, reaction coming on 
almost immediately thereafter. Hence many of the weak and 
invalided can bathe in sea-water, but cannot bathe in fresh-water. 
Hence, in cases of dyspepsia and debility, it is usually advisable 
to add salt to the water: about half a stone of common salt to 
the ordinary sized bath may perhaps be considered to be an 
average quantity. 

"2d. If only part of the body is immersed. In this case the 
chilling is not so great. But except as a means of ablution, 
partial bathing is not, under ordinary circumstances, of much 
service. 

" 3d. If the water is merely applied to the body. The shower- 
bath seems to chill even more than the plunge-bath, but the 
reaction takes place much quicker ; and therefore in some cases 
it is to be preferred. The shower-bath is a convenient mode of 
bathing, one readily introduced into a house, one in which, as I 
have just said, reaction soon follows ; but it is certainly not com- 
parable, as a remedial agent, to bathing by immersion, and 
should in very few and rarely occurring cases be preferred to 
it. Even in cases of head-affection, to which, of all kinds of 
cases, the shower-bath is generally thought to be best adapted, 
if the precaution were taken of dipping the head in cold water, 
and wetting it thoroughly before entering the bath and fre- 
quently while in it, the plunge-bath is, I think, almost always 
the better. 

" There are few customs so conducive to health as sponging the 
surface of the body all over with cold water every day. From 
this the chill, unless at first, or unless the system is debilitated, 
is trifling, the reaction instantaneous, and the benefit, I am 
satisfied, not to be credited until after trial. I have said that 
the skin is constantly secreting a fluid called perspiration ; but 
besides this it is always covering itself over, when the system is 
in a state of moderate health, with an unctuous or oily secretion, 
probably as a means of preserving its elasticity and softness 
and of rendering it a still worse conductor of heat. Now this 
unctuous secretion is not, like the perspiration, soluble in the 
air, but it remains on the skin, and, mixing with the exfoliated 
scales, or particles of the cuticle, forms a crust over the skin, a 
crust partially, but only very partially, removed by the move- 
ment of the limbs and body or by change of clothes. This 
crust not only irritates more or less, giving rise to many inde- 
scribable and perhaps highly injurious and certainly very an- 
noying feelings of uneasiness and discomfort, but it actually 
interferes with the proper and adequate exercise of the functions 
of the skin. Sponging the surface removes these unctuous and 
scaly particles, frees the skin from sources of irritation and in- 



230 SPONGING WITH COLD WATER. 

cumbrance, and enables its functions to be discharged without 
impediment. If this were the whole advantage which attends 
the practice it is probable that enough would have been said to 
make every thinking reader adopt it ; but this is not all the good 
which the regular use of cold water, as an external application, 
involves. No matter how used, whether by sponging, or the 
shower-bath, or immersion, cold water excites the action of the 
vessels of the skin, gives them tone, enables them to resist the 
influence of the ordinary vicissitudes of the weather, and thus 
wards off disease to a very remarkable extent. 

"If sponging with cold water alone produces too great a chill- 
ing of the surface, is not followed by brisk and speedy reaction, 
vinegar, or better still, salt, may be added to the water in the 
proportion of one part of vinegar to three or four parts of water, 
or a pound and a half of salt to the gallon of water.* If even 
this is not followed by quick reaction, if the system does not 
readily recover its warmth, a little warm water may be added at 
first, gradually adding less and less warm water to it until it is 
brought down to cold. 

"Another practical fact must be mentioned. The skin is 
covered over with an oily secretion, which subserves many im- 
portant ends, not one of the least of which is to increase the non- 
conducting powers of the skin in defending the body from the 
effects of an elevated temperature, and in checking the evolution 
of its heat when it is placed in a temperature lower than its own. 
One necessary effect of sponging the surface is to remove this 
oily secretion, and the skin is therefore not so protected until 
the oily matter is again evolved in sufficient quantity to cover its 
surface. This, if the man is in perfect health and in full 
possession of his powers, takes place in a very brief space of 
time ; but if the person is out of health, his secretions irregular, 
and his system debilitated, it will probably be several hours be- 
fore it is accomplished. Under such circumstances the sponging 
should be used only at night, just before or even after getting 
into bed, for the body is then protected by the bed and bed- 
clothes from the influence of the cold air, and in the morning 
the skin is once more covered with the oily secretion and once 
again prepared to come into contact with the cold air without 
risk. 

"While on this subject, I will just allude to the practice in 
which many unthinkingly indulge of washing themselves, par- 

* I am in the habit of ordering four or five pounds of salt to be dissolved in 
a bucketful of water, and placed in the bed-room or dressing-room, and this to 
be changed once or twice a week. This will be found to be often enough, and 
the convenience is much greater than making every day a fresh solution of salt. 



BEBEERINE. 231 

ticularly during the winter months, in warm water. There are 
few habits which so predispose the system to suffer from the 
effects of cold. I have traced many cases of frequent sore- 
throat to this practice alone, and their recurrence has been pre- 
vented by simply washing the face and neck with cold instead 
of warm water. 

" Friction alone is generally a useful and advisable and ener- 
getic means of giving vigor, activity, and tone to the vessels of 
the skin. The flesh-brush furnishes us with the best means of 
using the remedy ; and a remedy it is in many cases of lingering 
disease, or protracted convalescence, or where, as in spinal cases, 
muscular exercise is not to be obtained. As an adjunct to bath- 
ing, the shower-bath, or sponging with cold water, friction is in- 
valuable ; every bather ought invariably to resort to it as a means 
of accelerating the reaction and increasing it in degree : the towel 
with which he dries his skin can hardly be too rough."* 

Bebeerine. Laurus Bebeerus. — Sir Andrew Halliday, in his 
work on the West Indies, speaks of this tree as far superior to 
any of the cinchonas for 'the cure of intermittents and remit- 
tents. He names Mr. Rodie, a naval surgeon, who resided in 
British Gruiana, and who made the preparation called bebeerine, 
and which he regarded as fully equal to the sulphate of 
quinine. 

The bark and seeds of the bebeeru tree contain two alkaline 
bodies, called bebeerine and sisseerine, from the Indian and 
Dutch names of the tree; and the sulphate contains both of 
these bases. 

Dr. Watt, of West Demarara, found from a scruple to half a 
drachm of the salt sufficient for a common intermittent. He 
sent some to a medical friend in North America, who cured a 
patient with nine grains. Dr. Blair, of the Seaman's Hospital, 
tried it in place of quinine in yellow fever, and found it to 
answer well in many cases, but came to the conclusion that it 
was inferior to the salts of quinine. 

Some who have tried it a good deal affirm that it is preferable 
to sulphate of quinine, as it does not induce that unpleasant ring- 

* As the warm bath is very generally employed in asphyxia, and especially in 
the case of new-born infants, it is proper to refer here to the sage remarks of 
Dr. Marshall Hall on this subject. 

He says, the warm bath, by accelerating the circulation and increasing the 
carbonic acid, poisons the system positively ; and by excluding the depoisoning 
process, is negatively poisonous also. It interferes with all proper efforts to 
restore or promote circulation and warmth. Very aptly does he refer to the 
history of the Grotto del Cane, in which the plunging of a dog into the dense 
carbonic acid so as to asphyxiate the animal has a prominent place. The dog, 
on being taken out, apparently dead, is plunged, not into a warm bath, but into 
the water of an adjoining lake, and he is restored at once. — London Lancet, 
Dec. 20, 1856. 



232 ESSENCE OF BEEF — BELLADONNA. 

ing of the ears nor the nervous uneasiness so often complained 
of as caused by the salt of bark. 

It is important for medical men to bear in mind the facts as 
they are presented, for it is quite possible that the supply of 
sulphate of quinine may at no very distant day be exceedingly 
uncertain. 

For the severest diarrhoea, the sulphate of bebeerine is held 
to be almost a specific by Mr. Mathews, of Manchester, England. 
In half an hour he has seen a patient pass from intolerable 
anguish to perfect ease, under this treatment. He gives at first 
a pill containing two grains of calomel and half a grain of opium, 
and sometimes applies a sinapism to the navel. Then the fol- 
lowing : — 

R. — Sulph. bebeerine, grs. xij; 
Acid, sulph., 
Ether, do., aa gtts. xij; 
Aq. cinnamon, ^vi. 

Mix. Give an ounce every four hours. — Dublin Hospital Gazette, Sept. 1854. 

Beef, Essence of.— This was a faVorite article of diet with 
the late Dr. Parrish, of Philadelphia, and it is often a very use- 
ful thing. To make it, take a pound of good beef, free of fat, 
cut into small bits, and put it in a porter bottle furnished with a 
cork, which must be kept in loosely. The bottle is to be placed 
in a kettle of water and kept there until the water has been boil- 
ing at least half an hour. As the ebullition goes on the cork 
may be made a little more secure, to prevent the contents of the 
bottle from escaping. The juices of the beef are thus forced 
from the fibre and collect in the bottle, constituting the essence. 
This is to be seasoned as may be most agreeable. It is exceed- 
ingly nutritious, and has the advantage of containing much nutri- 
ment in a very small bulk. 

Beef Tea. — This is sometimes confounded with the essence. 
It is a much weaker preparation in point of nutritious qualities, 
and yet often found useful. It is made by boiling beef without 
fatty portions in a given quantity of water, so as to impart to 
the latter the taste and the nutritive quality of the flesh. Even 
if a pound be boiled in a quart of water, and for the space of 
an hour, the fluid will be far below the essence as a means of 
nutrition. It is taken in larger quantities however, and, with 
grated crackers or toasted bread, makes a pleasant kind of soup. 
It should be seasoned as may be most agreeable and proper. 

Belladonna. Atropa Belladonna. Deadly Nightshade. 
The leaves and berries. Atropa, from Atrophos, one of the 
fates ; belladonna, a beautiful lady. — Either the leaves or berries 
will induce delirium, stupor, dilatation of the pupil, convulsions, 
efflorescence of the skin, and death if taken in large quantities. 



POISONOUS QUALITY OF BELLADONNA. 233 

It sometimes happens, from peculiarity of constitution, that an 
ordinary dose will bring on alarming symptoms and compel us 
to lay the medicine aside. And, owing also to some unknown 
constitutional state, or possibly to some defect in the article, 
forty-six grains of the extract have been exhibited at one dose 
without serious injury. There was a general scarlet redness of 
the surface, with dilatation of the pupils, but prompt treatment 
prevented a fatal issue. 

The Journal de Chimie Medicate for 1839, reports the case 
of a man who recovered after having accidentally taken two and 
a half drachms of the extract. He became drowsy, agitated, 
and delirious. His tongue was very red and dry, pulse one 
hundred and twenty,, face injected, eyes suffused,- pupils dilated 
to the maximum. The delirium increased so that six persons 
could scarcely hold him. He was bled freely, and vomited with 
tartar emetic. Acidulated drinks were given, clysters employed, 
and a little ether administered. Leeches were placed on the 
epigastrium, and the warm bath resorted to. The recovery was 
rapid. In the London Lancet for February 2, 1839, mention 
is made of recovery after nearly an ounce of extract had been 
swallowed. The particulars are not given. We presume that 
the extract had been spoiled in the preparation and therefore 
lost its power. 

In Buchanan s History of Scotland, it is said that the invad- 
ing army of Sweno was destroyed by the Scots with the juice 
of belladonna berries mixed with wine, with which they supplied 
the Danes during a truce. High intoxication followed, and the 
Scots, taking advantage of it, fell on them and nearly extermi- 
nated the whole. It is also matter of history that one hundred 
and fifty soldiers were poisoned by the berries, which they igno- 
rantly gathered near Dresden. And young children, unaware 
of the nature of the article, have often been poisoned in the 
same way. 

Koestler, in the Medicinisclie Jahrbucher, reports the symp- 
toms in a family poisoned by eating more or less freely of the 
berries. The family consisted of the father, two sons, and two 
daughters. The youngest children ate the most, and in them the 
effects were most striking. They became restless and delirious. 
Their ravings were on lively subjects only. They experienced 
loss of vision, extreme dilatation and immobihty of the pupils, 
spasms of the face, great heat in the oesophagus, difficulty in 
swallowing, high excitement of the genitals, and involuntary 
discharge of urine. Frequent bending forward of the trunk of 
the body, and constant motion of the hands and fingers, (symp- 
toms noticed by some writers,) were not seen in these cases. 

But cases of fatal issue from eating the berries are very nume- 

16 J 



234 ACTION OF BELLADONNA ON THE EYE. 

rous; and if the one sometimes cited, in which a pound was 
swallowed, be founded in truth, there must have been something 
peculiar about it to protect the system from the poisonous in- 
fluence. The man might have taken a large dose of laudanum 
or some other narcotic ; or he might have swallowed a portion of 
tartar emetic, so that the berries would have acted as an antago- 
nist force, and thus the system might have escaped unhurt. 

In some cases so much of the poison has been swallowed as 
to paralyze the stomach and render it necessary to administer 
prompt emetics. These should be given immediately, or the sto- 
mach-pump should be resorted to. After the poison is ejected 
vinegar and water should be administered, to restore the lost tone 
of the stomach. An Italian, Dr. Chiovitti, has announced the 
flowers of zinc as an antidote. He gave it to a favorite horse 
accidentally poisoned with a half-ounce of belladonna. Three 
ounces of the antidote were given, and in twelve hours the horse 
was well. 

To test the quality of the leaves or the extract we must ascer- 
tain its effect on the eye. An infusion, made of a drachm of the 
leaves added to a half-pint of boiling water, should induce dilata- 
tion of the pupil of several hours' duration simply by dropping 
it between the lids and covering the eye with a pledget soaked in 
it for fifteen minutes. The extract, softened into a thin paste 
with warm water and rubbed over both eyelids, should have the 
same effect in the same length of time, or, at furthest, in half an 
hour. It is important to know by these means what is the quality 
of the medicine before we attempt to put its preventive power, in 
reference to scarlatina, to the test. If the article be good for 
nothing, of course no sane man would censure belladonna for a 
failure. Now in making the extract it happens that, from a 
desire to finish the operation speedily, too much heat is applied, 
and in place of mere evaporation of the strong decoction the 
inspissated matter is actually burnt, decomposed, ruined. It is 
not difficult to prepare a good extract. All we have to do is to 
make the strongest possible decoction of the leaves, and gradually 
to evaporate the filtered solution to a paste. This will become 
sufficiently dry for use spontaneously. Made thus, the extract 
has a yellowish-brown color, smells like the plant, and is soluble 
in alcohol and water. One grain dissolved in a drachm of cold 
water will make a mixture strong enough to dilate the pupil if a 
few drops be made to fall between the lids. The vision will be 
confused for twenty-four hours. 

Such an article it was, doubtless, that Hahnemann first em- 
ployed to prevent attacks of scarlatina, a power which I believe 
the medicine in its genuine state really possesses. And I am 
forced to conclude that the rejection of the preventive, uncon- 



PROPHYLACTIC USE OF BELLADONNA. 235 

ditionally, by some physicians who profess to have tried it, must 
be ascribed to the fact that an inferior or inert article was tried. 
That a good extract will set up a state of the skin resembling- 
true scarlatina is certain, and, added to this, we generally find 
dilatation of the pupil as a concomitant. 

Hahnemann first published on this subject, in 1801. The next 
writer of any note was Dusterling, who announced his experi- 
ence in 1820; his paper appeared m Hufeland's Journal. Scar- 
latina was then prevalent in Gusterlop, Germany, as an epidemic ; 
and he gave daily, to all the children who had never had the dis- 
ease, from ten to twenty drops of a solution made by dissolving- 
three grains of the extract in a half-ounce of cinnamon or ca- 
nella-water. All who took this medicine for one week escaped the 
disease, while the rest suffered. In 1829, Dr. Oppenheim gave 
the belladonna to the troops and citizens of two adjacent villages 
in Germany. He mixed thirty-six grains of the extract with 
one pound of softened liquorice ball, and gave ten grains of the 
mixture to each adult morning and night. The success was 
great, beyond expectation, for only twelve out of twelve hun- 
dred thus treated took the disease. The extract was given in an 
aromatic water to one hundred and sixty children in a Prussian 
asylum about the same time with similar success. Dr. Maclure 
published his experience in the London Medical Grazette for 
1838. He succeeded completely, but says that the preventive 
does not always induce scarlet efflorescence nor dilatation, even 
when it prevents an attack of the epidemic. He gave twenty 
drops every night of a solution made by adding eight grains to 
an ounce of dill-water. This dose was probably for adults. 

In Valenciennes, in 1846, four hundred children were treated 
with the belladonna to save them from scarlatina, then prevailing 
as an epidemic in the vicinity. All escaped, although only six 
had any efflorescence, and. in one hundred and forty-five there 
was no apparent local manifestation of any kind. 

Dr. Newbigging has recently tested the preventive powers of 
belladonna in a public institution, where seclusion had failed to 
arrest the spread of the disease. He gave the extract in doses 
of a sixth of a grain with marked success. — Edinburgh Monthly 
Journal, September, 1849. 

Bell's Bulletin of Medical Sciences for February, 1846, con- 
tains American testimony equally satisfactory ; and I add, that 
I have employed the extract with such decidedly preventive, effi- 
cacy that it would be folly or madness to doubt. Again and 
again have I prescribed the aromatic solution, and have not only 
gained the desired result, so far as the prevention was concerned, 
but have allayed the perturbation of nervous mothers effectually 
by exciting their confidence and enlisting their fixed attention to 



236 INTERNAL USE OF BELLADONNA. 

its careful administration. This alone is worth all the trouble 
of the prescription. 

The practice I prefer is this : — supposing the children to be 
four or five in number and to vary from eighteen months to 
seven or eight years of age, a mixture of three or four grains to 
the ounce of cinnamon-water is directed to be given three times 
a day to each child, in doses of from half a teaspoonful up to a 
teaspoon and a half. This course is pursued for a week, and the 
medicine is then intermitted for two or three days, and then re- 
sumed as before. I have never yet seen any untoward results 
from this administration. Children like the dose, the parents are 
gratified, and the end is gained. 

Hahnemann at one time gave forty drops in seventy-two hours 
of a solution of which one drop contained a millionth part* of a 
grain of the extract of belladonna, as a preventive of scarlatina. 
Would not a candidate for graduation richly earn a diploma by 
figuring out the precise quantity of extract taken by the patient 
every hour and weighing out each dose ? 

While the journals everywhere contain very high encomiums on 
these alleged prophylactic powers, it is but just to add that many 
physicians have no confidence whatever in the statements. We 
have ; and are sure, at all events, that no mischief can result 
from a wise trial. 

Several English, German, and American writers speak favor- 
ably of the extract of belladonna in the treatment of pertussis. 
To a child eight years old an eighth of a grain dissolved in a little 
syrup or cinnamon- water is given every four hours. This dose 
may be increased to a fourth of a grain, if need be, with safety. 
The coughing spells are lessened in number, and their violence is 
abated. The medicine usually sets up a slight efflorescence, with 
some fever, and suffusion if not dilatation of the eye, a little 
headache, and perhaps dimness of vision. Indeed, these symp- 
toms have sometimes predominated for a time so as wholly to 
suspend the spasmodic cough. 

In 1784, Dr. Buchhave, of Copenhagen, published his experi- 
ence in the use of belladonna in hooping-cough. He employed 
the powdered root, and found it to induce efflorescence of the sur- 
face, dilatation of the pupil, &c, and to shorten the disease very 
obviously. This practice most probably led to the use of the 
extract for the same end. 

The powder and infusion of the leaves, as well as the extract, 
have long been employed in epilepsy, chorea, and mania, and in 
all the neuroses. But at present few physicians resort to the 
medicine in either of these diseases. 

The extract of belladonna has acquired some repute in the 
management of incontinence of urine, especially in a hospital 



EXTERNAL USE OE BELLADONNA. 237 

for sick children in London. Children laboring under the in- 
firmity from the day of birth have been relieved and cured by 
the use of small doses persisted in for the space of two or three 
months. To a child eight years old an eighth of a grain was 
given at first, night and morning, and the dose was gradually 
enlarged to a sixth of a grain. — British Med. Journal, March, 
1857. 

Inhalations of the vapors emitted by a strong decoction of the 
leaves of belladonna have been successfully tried in asthma. The 
O-azette Medicate for December, 1834, has some interesting facts 
in this relation. Two drachms of the leaves were boiled for ten 
minutes in a pint of water, and the inhalations made while the 
fluid was hot and continued as long as the patient could bear. 
It is added that the inhalations were specially suited to dry 
asthma, with convulsive cough, and that it is necessary to in- 
crease the strength of the decoction so as to have a half-ounce 
of the leaves in a pint. Of eleven patients nine were cured and 
the others much relieved. 

The external medication is often very important. The oint- 
ment of the leaves, made by gently stewing a drachm of the fresh 
article in an ounce of hog's lard, is an admirable application to 
the perineum for the relief of chordee, and is often very soothing 
to irritable ulcers. A softened extract made into a plaster has 
been applied over the region of the heart to allay -palpitation, 
with excellent effect ; and the same has also been laid over the 
perineum, to relieve the bladder in a state of irritation, with 
prompt effect. The extract should be spread on soft leather and 
renewed every few hours. 

Dr. Hall, of Scotland, has published some very interesting re- 
marks on the agency of extract of belladonna in allaying inflam- 
mation and pain. He thinks it has special power to arrest in- 
flammation. He gives the case of an inflammation and enlarge- 
ment of the testicle from a wound, accompanied with severe pain, 
in which the usual remedies failed. The parts were coated with 
a strong solution of the extract, or rather a paste. He made the 
application with a soft brush, and found that a single trial gave 
obvious relief, the pain and swelling being much abated. Under 
three applications made in the course of three days the parts re- 
gained their natural appearance. Dr. Hall says he has often 
tried this plan in cases of erysipelas and orchitis, or inflamma- 
tion of the testicle and spermatic cord. 

The softened extract is also very useful in many cases of neu- 
ralgia and rheumatism of a strictly local nature. 

The following account of the use of extract of belladonna was 
given to the Academy of Sciences in Paris, in April, 1853, by 



238 ATROPIA, HOW PROCURED. 

M. Poggiale, who read a memoir on the subject. He called the 
disease sciatic neuralgia. The formula is as follows : — 

Extract of belladonna, 5 parts ; 

Hydrochlor. morphia, 1 part ; 

Simple ointment, 16 parts; 

Lard macerated with stramonium leaves, 1 part ; 
Essence of lavender, 30 drops; 

Mix intimately, and apply by gentle and prolonged friction. 

Ten cases were cured, all having been remarkable for their 
long duration, failure of previous remedies, and the rapidity and 
perfection of recovery under this treatment. 

The paste of the extract alone, applied to a raw blistered spot 
on the spinal column, has given prompt relief. — London Lancet, 
1850, vol. ii. p. 263. 

In December, 1856, Dr. Goolden published an article on the 
use of extract of belladonna to arrest the secretion of milk ; and 
another paper, in confirmation, has been given by Mr. Burrows, 
of Liverpool, in a foreign journal for March, 1857. 

The extract, reduced to a soft paste, was painted over the 
areola around the nipple pretty thickly, and in thirty-six hours 
after the breast was cool, pale, and placid, the knots much 
softened and lessened in size. The painting was repeated, and 
in three and a half clays after the first application the knots could 
scarcely be felt. The secretion was also satisfactorily checked. 

Dr. Willey, of St. Paul, Minnesota, has published some cases 
in the Cincinnati Medical Observer for April, 1857, confirming 
the above account of the use of belladonna extract. 

One of the most striking results of the use of the softened ex- 
tract is in the treatment of delirium tremens. A blister having 
been applied to the upper portion of the spinal column, and the 
cuticle removed, the softened extract is applied to the raw sur- 
face. The effect is very speedily to quiet the patient, and ulti- 
mately to put him to sleep. Sometimes the counter-irritation is 
severe, and it is necessary to remove the plaster for a few 
minutes. The reapplication insures a return of quietude and 
even sound sleep. 

I have no doubt that a similar use of the extract would be an 
excellent auxiliary to the best modes now in use for the treat- 
ment of tetanus and hydrophobia. 

The proximate principle of belladonna is called atropia or 
atropine, containing all the power of the plant in a concentrated 
form. It is extracted by digesting the leaves in diluted sulphuric 
acid, after which potash is added to detach the acid and throw 
down the atropine. This is collected on a filter and well washed 
and dried. The dose is from one-sixteenth to one-fourth of a grain, 
and it is regarded as a direct sedative and eminently poisonous. 



BENNE PLANT — BISMUTH. 239 

Belladonna may be administered so as to prove stimulant, nar- 
cotic, diaphoretic, diuretic, rubefacient, and counter-irritant. 

Benne Plant. Sesamum Orientate. — The seeds, leaves, and 
oil are used. It has been known for many centuries, and esteemed 
for its remedial qualities. Though a native of India, it has been 
cultivated in the West Indies and in this country, where it grows 
and thrives. It is an annual plant, bearing reddish-white flowers, 
and yielding an abundance of oleaginous seeds, which constitute 
an article of food in some places. The seeds yield an oil by ex- 
pression, which is a good substitute for sweet oil. 

The leaves contain a good deal of mucilaginous matter, readily 
extracted by water, and so furnish a mild demulcent drink, highly 
esteemed for the relief of catarrhs, bowel affections, and irrita- 
tion of the urinary organs. For a time the summer-complaints 
of children were treated largely with this article, and it still 
retains its popularity to a certain extent. Two or three leaves 
placed in a half-pint tumbler of water will soon make the desired 
mucilaginous drink. If the leaves be green cold water will an- 
swer ; if dry hot water is better. Being a very bland article it 
may be taken without limit. The demulcent quality is well suited 
to allay irritations of the eyes, bladder, skin, &c. 

The seeds can be had in any of our seed-stores, and should be 
sown in good soil in April or early in May, and the plants should 
be set out a foot apart when they reach the height of four inches. 

Bignonia Ophthalmica. Eye-root or vine. Akuserunee, 
&c. &c. — The juice of this plant is reported by Dr. Chisholm, of 
Grenada, as a remedy long employed by the Indians for inflamed 
eyes. A single drop of the juice pressed into the eye affords ob- 
vious relief, and a repetition on three or four succeeding days 
completes the cure. It is named as a very peculiar circumstance, 
that the moment the drop of juice is placed in the eye the patient 
has a sweetish taste on the tongue. (See Med. Commentaries, 
vol. x.) I know nothing of this plant from any personal observa- 
tion, but think it may be entitled to consideration. 

Bismuth. — This metal has a silvery lustre and color and a 
foliated texture, melting at 460°, with a specific gravity of 9.5. 
In its metallic state it is wholly inert ; and the only preparation 
having medicinal properties is the white oxide, called dinitrate 
and trisnitrate, the latter indicating its real composition, viz., 
three equivalents of oxide of bismuth to one of nitric acid. 
Dissolve an ounce of pure bismuth in an ounce and a half of 
nitric acid, to which six ounces of water have been previously 
added. The solution is next to be filtered, and three pints of 
distilled water added to the clear liquid. In this process the tris- 
nitrate is thrown down as a white powder, which must be col- 
lected on a filter, washed with pure water, and dried. The pow- 



240 USES OF BISMUTH. 

der thus obtained is of a dull white, is inodorous, tasteless, nearly 
insoluble in water, easily soluble in nitric acid, changed to a gray 
color by exposure to light, and of course should be kept excluded 
from the light as much as possible. 

This preparation has "the property of arresting secretion by 
virtue of its astringency. But it has been chiefly used for the 
relief of painful affections of the stomach, as gastrodynia, when 
it is supposed to act as a sedative, although some regard it as 
tonic and antispasmodic. Some thirty-five years ago this medi- 
cine excited a good deal of interest in the profession. Then 
dyspepsia was the great medical hobby, and everybody was look- 
ing to remedies suited to its cure. Dr. Moore, of New England, 
wrote a thesis on the use of the white oxide of bismuth in dys- 
pepsia, and lauded its powers very highly. He found that it 
improved the digestive organs, invigorated the appetite, and 
soothed the gastric pains. Hence he came to the conclusion 
that it possessed tonic and sedative properties. The best form 
of exhibition was found to be in pills made with soft bread or 
dough. The dose was four grains three times a day, gradually 
increased to twelve or fifteen. If it occasioned obvious gastric 
uneasiness, a soothing dose of opium was added. Very large 
portions induced gastric distress, giddiness, cramps, &c. There is at 
least one case of fatal poisoning on record, induced by two drachms 
swallowed by mistake at once, death occurring on the ninth day. 

The old-fashioned doses of this article sink into utter insig- 
nificance when contrasted with the bold prescriptions of M. Mon- 
neret, who has given the results of his experience in Gazette 
Medicale for June, 1849. 

In various forms of diarrhoea, in cholerine, the usual precursor 
of Asiatic cholera, in gastralagia and vomiting, he gives it most 
liberally. So large are the quantities named in his prescriptions 
that the apothecaries hesitate to put them up. "From whatever 
cause pain manifests itself during digestion," says Dr. M., "we 
may relieve it by mixing the sub-nitrate freely with the articles 
of food." He has never given less than two or three drachms 
daily, nor more than twenty. He declares that he never saw any 
inconvenience to follow these doses, and that he gives it to chil- 
dren in his hospital by tablespoonfuls, without observing nicer ex- 
actitude, so innocuous does he regard it. 

We are not prepared to deny the truth of these statements, 
but really it does seem to us that such wholesale administration 
looks very like an argument in favor of the poetry of homoeopathy. 

Prof. Caizergues, of Montpelier, administered the remedy in 
more moderate doses, combined with extract of belladonna. Thus : 

R. — Sub. nit. bismuth, 160 grs; 
Ext. bellad. 16 grs. 

Mix, to make forty pills, two of which to be taken night and morning. 



BITTERA FEBRIFUGA — BLACK LINT. 241 

Pereira says lie has derived advantage from the white oxide in 
the form of ointment to ulcers of the septum nasi, and to some 
cutaneous diseases. For this end he added a drachm of the 
powder to an ounce of spermaceti ointment. Hahnemann ad- 
vised two or three grains of the powder to be dropped into the 
cavity of a decayed tooth as a remedy for the toothache. 

It is well to know that after the internal use of this powder 
for a very short time the stools are very much altered in color, 
assuming almost a black appearance, owing to the chemical action 
of the sulphuretted hydrogen gas in the bowels. This gas, con- 
tained in a bladder, has been designedly brought in contact with 
the oxide on the cheeks of ladies, employed as a cosmetic, with 
a like result. The hue instantly changed to black. 

Touching the poisonous action of the white oxide of bismuth, 
we have to say there is no antidote. All that can be done is to 
empty the stomach speedily, and then to give emollient or muci- 
laginous drinks freely. If inflammation of the stomach super- 
vene, leeches must be applied to the epigastrium, and the anti- 
phlogistic treatment pursued. 

Bitter Apple. (See Colocynth.) 

Bittera Febrifuga. — The practitioners of Martinique have 
sent to Europe very favorable accounts of the febrifuge virtues 
of a plant found there, to which the name bittera febrifuga has 
been given. It is popularly known at Martinique as the bitter ash. 
The active principles reside in a bitter resinoid and in a substance 
styled bitterine, analogous if not identical with quassine, obtained 
from the quassia amara. 

The plant is given in powder, infusion, and extract, and the 
bitterine itself in pills. M. Delioux has, as yet, tried only the 
extract made into pills, of which he gives from one to fifteen 
grains during the pyrexia. This practitioner holds the new 
article to be inferior to the salts of quinine, but superior to ar- 
senical preparations. Its intense bitterness makes it repulsive. 
— Med. Times and G-azette, April, 1857. 

Blackberry. (See Rubus trivialis.) 

Black Drop. (See Opium.) 

Black Lint. — In a recent paper in the London Lancet for 
June, 1850, Mr. Higginbotham gives a formula for what he calls 
black lint, an article employed by him in the treatment of large 
ulcers. It is as follows : — 

Nitrate of silver, two drachms ; 
Distilled water, four ounces. 
Mix, and make a solution. 

Saturate an ounce of fine lint in the solution, expose it in a 
flat, shallow vessel, and thus let it dry by evaporation. The 



242 BLOOD-LETTING. 

ulcer is to be covered with a piece of the black lint so prepared, 
and over this is to be laid a plaster of neutral ointment, con- 
sisting of lead plaster, eight ounces ; sweet oil, eight ounces ; 
prepared chalk, four ounces ; distilled vinegar, eight ounces ; all 
thoroughly incorporated so as to make a homogeneous mass. 
These are confined by means of compress and bandage, and re- 
quire to be renewed only every third or fourth day. The salu- 
tary action of the nitrate of silver is constant, and hence more 
effective than when applied once in a day. We think the expe- 
dient worthy of particular notice. It has been resorted to for 
the arrest of bleeding from leech-bites, in burns and scalds, 
erysipelas, &c. &c. 

Blistering-point. (See Cantharides.) 

Blood-letting. Venesection, arteriotomy ', cupping, leeching. 
— General bleeding includes venesection and arteriotomy, while 
local bleeding is performed by cups and leeches. 

The primary or direct effect of blood-letting is sedative. It 
reduces the actual quantity of the vital fluids, and abstracts a 
portion of the vital power directly. Sometimes the sedative 
effect is very transient, and high reaction ensues, with a bounding 
pulse and general glow of the system. So great is this reaction 
often that free depletion is needful to subdue the pulse to the 
natural state. During life and in tolerable health the blood- 
vessels have a certain state of tension by which the force of the 
system is kept up. Blood-letting usually diminishes that tension, 
and relaxation and debility ensue. Under such circumstances 
the effect of detracting blood is decidedly sedative. 

The train of symptoms attending loss of blood is pretty uni- 
form. After a certain quantity is drawn a slight amount of 
dizziness is felt ; singing in the ears ; loss of consciousness ; re- 
spiration more or less hurried ; pulse enfeebled ; face becomes 
pale and moist with perspiration, and there is some sickness of 
stomach. This combination of effects indicates impairment of 
the functions of the brain by reason of abstraction of its natural 
and needful stimulus ; and, as an immediate consequence of this 
state of things, respiration suffers more or less. The enfeebled 
action of the heart and arteries results from defect in quantity of 
the blood and want of proper change in the lungs. 

The constitutional effect of the detraction of blood depends 
much on the mode and circumstances under which it is done. If 
the orifice is very small the blood dribbles away, and a long time 
is required to get a few ounces ; and hence no impression is made 
on the disease. If the operation is performed when the patient 
is standing or sitting, and from a large orifice, so that the blood 
is drawn rapidly, the system is promptly impressed, even though 
a large quantity be not abstracted. The tension of the vessels is 



RULES FOR THE USE OF THE LANCET. 243 

quickly subdued ; so suddenly often that time is not allowed to 
adapt themselves to the change. For the same reason arterio- 
tomy induces syncope sooner than venesection. The practical 
application is obvious. If you wish in a short space of time to 
induce syncope, and thus secure a prompt impression, bleed from 
an artery, or from a vein with a large orifice, and in the erect 
posture. I shall never forget the first time I witnessed the effect 
of bleeding a patient while on his feet. A raving maniac in the 
Pennsylvania Hospital was bled in both arms under these circum 
stances. Before twenty ounces of blood had escaped big drops 
of perspiration began to fall, the face became pale, and the man 
fell. He was calm and subdued. Four times as much blood 
taken in the horizontal position would have failed to do as much. 

Arteriotomy is not often resorted to excepting in very urgent 
cases, as apoplexy, phrenitis, &c. It enables us to make a more 
direct and permanent impression on a violent disease of a very 
important organ than we can induce by venesection. 

There are some circumstances related to the operation of 
blood-letting that claim particular notice. As a general rule you 
can bleed with more safety between the ages of eighteen and 
forty-five than at other periods. We do not mean to say that 
infants, young children, and old persons, should never be bled ; 
by no means. In grave diseases of the brain or lungs we may 
resort to this remedy no matter what the age may be. Yet I 
am well satisfied, from a good deal of observation, that patients 
have often been bled needlessly at all ages. In my early medi- 
cal career I bled almost everybody for almost every complaint. 
The remedy was prompt, and often did good undoubtedly. As 
I became more and more occupied, and in a country location, too, 
it was found that time could not be spared for the performance 
of the operation, and to economize time the lancet was less fre- 
quently employed. Other means were tried, and with equal suc- 
cess, and hence blood-letting fell into comparative disuse. Still, 
however, it is a valuable remedy, but calls for discretion. 

In all doubtful cases the young practitioner as soon as he 
opens a vein should place his finger on the pulse to watch the 
effect. If it flag evidently, the orifice should be closed. If it 
rise and expand in volume, let the stream flow till you are satisfied 
the remedy has done its work. The oppressed pulse is directly 
opposed to a pulse depressed. The former will rise as you bleed, 
while the latter will rapidly sink. 

The irritable pulse is often very embarrassing. Often, too, it 
is an artificial result, and the doctor has no one to blame for it 
but himself. He has bled and bled again because he erred in 
regard to the pulse, and he has only augmented the existing irri- 
tability. He fancied there was tension when careful observation 



244 BLEEDING IN ASIATIC CHOLERA. 

would have discovered nothing but debility. Mild tonics and 
good diet meet the case far better than the lancet, and sometimes 
active stimulants are called for. This is often true in the debility 
induced by uterine hemorrhage, as all experienced practitioners 
know. 

It is not my purpose to name the forms of disease in which 
blood-letting is proper and even demanded. But it seems to be 
right to notice the experience of distinguished physicians touching 
the effect of this remedy in Asiatic cholera, as that fatal disease 
may again desolate our country. There has been much diversity 
of opinion as to the value of bleeding in this disease, and we de- 
sire to impress on all minds the truth that even cholera may be 
so modified by place and circumstances as that the same remedy 
shall succeed and fail in different places. We see these opposite 
results in respect to yellow fever and other diseases, and it should 
not excite our wonder. It is very certain that some of our own 
physicians have had remarkable success in the use of the lancet 
in cholera, and the failure of others to find the same result can- 
not nullify the positive testimony on this subject. 

The following article, taken from the New York Journal of 
Commerce of January, 1849, contains important testimony, 
which merits attention. 

"Extracts from a letter from Dr. Evan to Dr. Jubres, dated 
Sevoor, (in the Deckan,) August, 1818 : — 

" 'As the cholera is still prevalent here, I think it may be 
acceptable to you to learn how matters are going on, and par- 
ticularly as I have it now in my power to afford you the most 
convincing proof of the decided superiority of bleeding in Euro- 
pean subjects. Since the 21st of last month, when the disease 
appeared in his majesty's 65th regiment, to the 10th of this 
month inclusive, one hundred cases of the disease have been 
admitted into the hospital. Of that number eighty-eight were bled 
freely on their admission, and only two have died ; while of the 
remaining twelve who were not bled no less than eight have fallen 
a sacrifice to the disease. This simple statement speaks volumes. 
In the first two days, Dr. Burrell, the surgeon of the 65th regi- 
ment, did not employ the lancet, but speedily found out the inef- 
ficiency of the common treatment. Of the twelve patients who 
were not bled, the greatest part were admitted on the first and 
second day, and about three or four since, with such symptoms 
of sinking as did not appear to him to render bleeding advisable. 
He now laments extremely that the scarecrow of imaginary de- 
bility should have deterred him from employing the only remedy 
which could have promised a successful result, as the appearances 
on dissection have but too well proved the necessity of such treat- 
ment.' 



BLEEDING IN ASIATIC CHOLERA. 245 

"Again Dr. Evan adds: — 'Dr. Moyles's practice in the Horse 
Artillery, and Dr. Campbell's in the 17th Dragoons, prove equally 
illustrative of the good effects of depletion.' Again: 'The irrita- 
ble and susceptible fibre of the natives of India will well account 
for the greater rapidity with which symptoms of exhaustion take 
place, and therefore there is the greater necessity for checking 
the disease in the very bud, if the patient can be had at this 
early stage. Dr. Burr ell's lancet has done this with great suc- 
cess. He has bled all the native patients belonging to the regi- 
ment, and the cases have been at least as numerous as those of 
Europeans, and exactly with the same result. But he gets them 
while there is yet a little vitality in the pulse and surface ; and 
however short this stage may be, it is a certain one, and the cure 
almost as certain. Upon the whole, this is his rule : — 

" ' In all cases where the stomach and bowels are affected, or 
when there are any spasms, even though the pulse is obscure and 
the extremities cold, open a vein and draw blood till an abatement 
or relief is procured. But in many cases it is necessary to bleed 
once and again, particularly if the spasms are violent, or the 
breathing oppressed, or the head affected. There can be no 
doubt that death in many cases takes place rapidly from the 
spasms extending to the large blood-vessels and heart itself. 
Such cases must exhibit an almost instantaneous appearance of 
sinking and debility ; but as in this case the powers of life are 
oppressed and not exhausted, I am confident that taking blood 
would remove the alarming symptoms.' 

" Dr. Coates, another eminent surgeon in the East India Com- 
pany's service, on the Bombay establishment, writes as follows, 
about the same date as the last letter : — 

" ' The symptoms you are already well acquainted with, and 
these symptoms were followed in every case that did well, after 
an interval of from twelve to twenty-four hours, with a feverish 
reaction ; that is, the skin became hot, the face flushed, and the 
pulse quicker and rather full. It does not appear to me that 
there is any necessity for such large doses as twenty grains of 
calomel. The laudanum and opium should not be pushed further 
than to stop the vomiting and purging, and to allay the cramps 
and pains. It soon occurred to me that the small, oppressed 
pulse could not proceed from debility, but must arise from tem- 
porary interruption of the flow of the blood through the heart. 
I therefore had early recourse to bleeding, and with the most 
marked good effects. In one case, that of a robust young man 
named Mapel, now belonging to the auxiliary horse, there was 
extreme suffering. He was quite frantic with pain, and there 
seemed even to be some delirium. A large dose of laudanum 
and calomel produced no relief. But when thirty ounces of 



246 BLEEDING: IN ASIATIC CHOLERA. 

blood were taken from him he was immediately relieved and 
fell asleep.' 

" The grounds upon which Dr. Jubres based his practice are 
briefly stated by him as follows : — 

" Without at all adverting to the origin or immediate exciting 
cause of this very formidable disease, it must be quite evident to 
every common observer that if the blood which now fills the 
vessels and warms the extremities should from any cause be 
withdrawn from them that blood must be somewhere in the 
system. It has not been withdrawn. It is not annihilated. 
It is not now in the superficial veins, for they are collapsed. 
The pulses at the wrist have ceased to beat, or beat very lan- 
guidly, and, in short, the swollen appearance of the hands and 
the feet at once bespeak the abstraction of the vital fluid from 
all these parts. It must be quite evident, then, that some of the 
internal vessels must contain a very undue proportion of blood, 
and dissections have proved this to be the case in the most satisfac- 
tory manner. What, then, I would ask, are the inferences which 
such theory and such facts oblige us to draw ? Surely in the 
first place to relieve the congestion of the internal vessels by 
copious bleeding, and in the next place to stimulate the heat and 
the vital powers into action. There is nothing more immediately 
stimulating to the internal system than heat, and hence the hot 
bath is strongly indicated, and my own practice substantiates the 
truth of this theory. 

" From what I have said above it will naturally be inferred 
that I should try the effect of blood-letting and the hot bath 
alone. The first case of cholera which occurred here, however, 
so strikingly exemplifies the advantages of bleeding and the hot 
bath, after calomel and opium had been given without any appa- 
rent effect, that I will shortly detail it. 

"A native soldier of the detachment which escorted a State 
prisoner from the Deckan to that garrison, was the first person 
seized with the disease. He was attacked about 7 a.m. and 
was sent to the hospital about 9 A.M., when my assistants had 
already given him twelve grains of calomel and forty drops of 
laudanum with peppermint. I saw him about half an hour after 
he had taken this dose. He still complained of great pain about 
the scrobiculus cordis, and generally over the whole abdomen. 
He bent forward with pain, his hands and feet were cold, with 
strong tendency to cramps in his legs, and there was a general 
restlessness and anxiety about him. He had vomited some 
calomel in fluid ; his pulse was very slow and oppressive, only 
forty-five in a minute ; he had not vomited since taking the 
calomel and opium, but as it had not afforded him the least 
relief, and the dose appeared smaller than had been usually 



BLEEDING IN ASIATIC CHOLERA. 247 

administered, I immediately gave him five grains more of calo- 
mel and twenty drops of laudanum, making altogether seventeen 
grains of calomel and sixty drops of laudanum, with a proportion 
of ammonia and peppermint. Hot fomentations were applied 
as early as possible, and I ordered a hot bath to be prepared for 
him. It was as hot as he could bear it ; and after he had been 
in it for a few minutes (at eleven o'clock, a.m., the bath was 
112°) the pain in the stomach and abdomen had left him and he 
felt much relieved. His pulse was now full and strong, and 110 
a minute, but intermitting irregularly. Notwithstanding the 
pain about the scrobiculus cordis had ceased, there was still a 
strong tendency to cramps in his legs. I bled him while in the 
bath to thirty ounces. The pulse no longer intermitted, and the 
tendency to cramps was quite removed. He felt, he said, quite 
free from pain. He was now put to bed and covered with blan- 
kets. One P.M., a general glow of heat upon the skin, which 
was moist ; but as he complained of some little pain about the 
scrobiculus cordis, forty drops of laudanum were repeated. Five 
p.m., feels quite well ; but having had no discharge from the 
bowels I gave him a purging draught, which completely relieved 
him. It is worthy of remark, perhaps, that no relief was in this 
case obtained from the calomel and opium, though it had been 
taken two hours and a half, and he was relieved in considerably 
less than ten minutes after he had been in the hot bath, and the 
tendency to cramps which still remained in his legs, as also the 
intermission of the pulse, were quite removed by bleeding. 

u As I am of opinion that cases illustrate facts in the clearest 
point of view, I cannot deny myself the pleasure of relating one 
case of the prevailing epidemic which was cured by bleeding and 
the hot bath alone, and, so far as I know, it is the first case that 
has been so cured. 

"A middle-aged man was attacked by the disease about two 
p.m. He walked with great difficulty to the hospital, supported by 
two of the nurses. He complained of excruciating burning pain 
about the scrobiculus cordis. He was bent double with pain, but 
he had not yet vomited or purged. His pulse was small and rather 
frequent, and the disease appeared to be making rapid strides. A 
hot bath was immediately prepared, and he was placed in it with- 
out delay. It was as hot as could be borne, and indeed it was 
some little time before he could bear it to be applied to his body. 
Measured by a thermometer it was 114°. The bath alone reduced 
the pain considerably about the epigastric region, but not im- 
mediately. I opened a vein while he was yet in the bath, and 
the orifice being large the blood flowed very rapidly. I allowed 
it to do so till the burning pain about the scrobiculus cordis had 
entirely ceased. At the time about twenty-six ounces of blood 



248 BREAD PILLS. 

had been abstracted. Taking him out of the bath he could 
scarcely be supported to a bed within five paces of it, when he 
fell senseless upon it. It was, indeed, a most complete fainting 
fit. He was covered with blankets, and I gave him a few drops 
of ammonia ; but it was some little time before he recovered his 
perfect warmth. In five hours he was so perfectly recovered that 
he left the hospital and went home, contrary to my advice and 
without my knowledge. I have seen this man repeatedly since, 
and he has not had the slightest return of pain." 

The use of the lancet, cups, and leeches, was once very fash- 
ionable and successful, too, in pneumonia ; but the times have 
changed, and practice too. Yet we discover that Dr. Addison 
has been bold enough, despite the objections urged by the sympa- 
thizers with homoeopathy, to resort to the old way in Guy's Hos- 
pital. He bled his patient to twelve ounces, gave him calomel and 
tartar emetic every six hours, with arrow-root for diet. The 
patient was cured. 

Blood Root. (See Sanguinaria.) 

Blue Mass. ) ro rr -, , 

Blue Ointment. }( See hydrargyrum.) 

Boneset. (See Eupatorium Perfoliatum.) 

Bread Pills. Pilulaz Panis. — The philosophy of the use of 
bread pills as a remedy is more complex than some may imagine. 
The prescription is an exceedingly simple thing in itself con- 
sidered, and owes its success not so much to any inherent medi- 
cal property .as to the effect induced on the mind of the patient 
by the contingencies of the case. In other words, we accom- 
plish good results with bread pills by inspiring the patient with 
confidence in the means, and by our wisdom in the device. His 
confidence is essential to salutary results. Without it, we pre- 
scribe in vain. 

The following case, which occurred during my pupilage, may 
serve as an illustration. A female consulted my preceptor (a 
worthy member of the Society of Friends) in relation to a dis- 
ease of long standing. It was plainly a hypochondriacal affec- 
tion, protracted and made worse by her sedentary habits. There 
was no evidence of organic disease in the system, and the good 
lady pretty clearly stated the case by announcing her desire to 
have something prescribed that would settle her nerves. 

The doctor listened to a long story with a pretty large measure 
of the patience of Job, but very soon decided what was to be 
done. He whispered in my ear to get some soft bread and make 
a box of forty pills, well scented with the oil of anise, and the 
suggestion was promptly carried out. With the box in his hand, 
the physician thus addressed the patient : " My friend, I think 
my student has made thee some pills that will be of great benefit, 



BROMINE. 249 

if taken according to my directions. Hast thou a clock or a 
watch at home?" The lady gave a negative reply. " Thou 
canst borrow a watch of a neighbor, perhaps?" "Yes, I think 
I can," was the rejoinder. "Well, then," said the doctor, "pre- 
cisely at nine, twelve, and three o'clock in the day, three of 
these pills must be taken. Mind and be particular to the minute, 
or I cannot give thee any encouragement. Everything now will 
depend on thyself. Do as I direct, and call when the box is 
empty and let us know the result." The patient's whole mind 
was concentrated on a single point — her confidence in the doctor 
was full and complete. She retired under the deep conviction 
that the doctor had fully analyzed her case, and that the pills 
would cure her. 

After the lapse of some days the patient was again at the 
office, and could scarcely find words to express her gratitude to 
the doctor. She declared that she had been improving every 
day since she began to use the pills, and now felt better than for 
ten years past. The box was renewed once or twice, and the 
recovery was complete. 

The expedient in the case named was every way justifiable, 
and it can be employed in similar cases with the most perfect 
honesty. There are hundreds of persons in every large com- 
munity who are wretched for years, imagining the presence in 
their systems of various diseases that the most accurate diagnosis 
cannot detect. The brain and nervous system are more impli- 
cated than any other portion of the economy, and the remedies 
addressed to that system, though powerless as articles of Materia 
Medica, often achieve valuable results. 

Bromine. Brome. — A simple or elementary substance re- 
sembling in some respects chlorine and iodine. It is obtained 
from the hydrobromate of potash found in sea-water. As the 
word imports, the article is exceedingly fetid. It is a reddish- 
brown dense liquid, emitting suffocating fumes. 

Both the simple substance bromine and the compound hydro- 
bromate of potash have been employed in medical practice, 
though not extensively. Dr. Pourche gives some account of it 
in the Journal de Ohimie Medicate of 1828, having tried it in 
scrofula, goitre, &c. He found that scrofulous tumors were 
dissipated by friction with an ointment of the hydrobromate of 
potash, or by poultices containing the aqueous solution of brome. 
In scrofulous enlargement of the testicle the same practice suc- 
ceeded, aided by the internal use of bromine. One part of 
brome to fifteen parts of water will give a proper solution. The 
dose is five drops in a little sweetened water, gradually increased. 

Bromine in any form acts on the glandular and absorbent 
system as does iodine. It is also rubefacient, and leaves a stain 

17 



250 BRUCIA — BUCHU. 

on the skin like that of chlorine and iodine. Sea-water is no 
doubt dependent on hydrobr ornate of potash for some of its good 
effects. 

Dr. Glover has published an article in the Edinburgh Medical 
and Surgical Journal for July, 1842, in which he says : — "The 
tonic and diuretic effects of bromine and its compounds were ex- 
perienced by a syphilitic patient who took the medicine." He 
also affirms that frictions of bromine induce an erythematous 
affection, preceded by a prickly sensation. 

The best antidote for the poison of bromine is starch, liberally 
administered in watery solution. 

Brucia. Brucine. — This is a vegetable alkaloid found in the 
angustura bark, in St. Ignatius bean, nux vomica, &c. It is 
very acrid and bitter, soluble in cold and yet more so in hot 
alcohol. Nitric acid strikes a red color with brucia, which is 
changed to violet by adding proto-muriate of tin. It has the 
properties usually ascribed to strychnine, and possesses one-sixth 
of the strength of the latter. The dose is a quarter-grain five 
or six times per day, made into pill with crumb of bread or syrup 
of acacia. Brichteneau and others prefer it because it may be 
safely given in much larger doses than strychnia. It has been 
administered successfully in bad cases of lead palsy. Beginning 
with one-third of a grain, it may be gradually augmented to 
twelve grains in a day. — Bulletin de Therap., January, 1851. 

Burdock. (See Arctium Lappa?.) 

Butternut. (See Juglans Cathartica.) 

Buchu. BuJcu. Biosma Crenata. The leaves. — This plant 
is an evergreen, and a native of the Cape of Good Hope. The 
word buchu is peculiar to the Hottentots, and has been variously 
spelled. 

An inexperienced eye might mistake the buchu for senna, 
from which it differs chiefly in its odor. It has a strong, diffu- 
sive, rather disagreeable smell, and a bitterish taste. The chief 
therapeutic property is that of a diuretic. It sometimes acts 
as a tonic, improving digestion by virtue of its slight bitterness. 
Carpenter, of Philadelphia, prepared a compound syrup which 
has been employed a good deal in gleets and gonorrhoeas. But 
any one can readily make the infusion or decoction of any de- 
sired strength, and the clear liquid can easily be converted into 
syrup ; and, if desirable, cubebs can be added. A half-ounce of 
the leaves added to a pint of boiling water will give the ordinary 
infusion. The dose is an ounce, repeated every three or four 
hours. 

Some of the medical journals report favorably of the use of 
buchu for the relief of irritable bladder, especially in old persons. 
Mr. Coulson, who has written ably on this subject, found nothing 



OIL OF CAJEPUT USED IN CHOLERA. 251 

so efficacious as buchu infusion persisted in for several weeks. 
The editor of the Medico- Chirurgical Review testified to its 
salutary action. Dr. M'Dowell, in the Dublin Medical Trans- 
actions, praises the infusion" for cases of irritable bladder, with 
enlarged prostate, depending on badly-managed gonorrhoea too 
hastily cured by astringent injections. 

I have prescribed buchu advantageously in gleets, and regard 
it as worthy the attention of medical men. A strong syrup, 
made as already indicated, should be freely taken, so as to exert 
a decidedly diuretic effect. 

Burgundy Pitch. (See Abies Excelsa.) 

CxUEPUTi Oleum. Oil of Cajeput. — The melaleuca cajeputi 
is the plant yielding this oil. Kyapootie is the original native 
word employed in Amboyna and Borneo, where the shrub grows 
abundantly. By distillation the leaves yield a greenish oil, and 
that is its appearance as we receive it from abroad. Some have 
fancied that the color is derived from the copper flasks in which 
it is placed for exportation. But there is not a trace of copper 
in it, the tinge being really caused by chlorophylle, or the green 
coloring principle of vegetable matter. 

This oil has a very agreeable odor, and its taste is pungent. 
It is lighter than water, and soluble in alcohol if not adulterated 
with turpentine. It is volatile. 

In Bengal the oil of cajeput has long been employed in the 
management of Asiatic cholera, in doses of from twenty to fifty 
drops every half-hour, given in a wineglassful of warm water, 
until the spasms cease. In this country the oil has been ad- 
ministered in connection with anodynes in the same disease. 
What the American theory of the modus operandi is I know not ; 
but the Bengalese doctors tell us that the pestilence is caused by 
a worm in the alimentary canal, which they are pleased to call 
the cholera worm, and that the oil kills the worm and so cures 
the patient. In plain language, they hold the remedy to be 
powerfully anthelmintic ; and whether they are right or wrong 
in this, no matter, if the medicine will really kill the worm and 
so arrest the cholera. 

The immediate effect on the stomach and bowels is to excite a 
very perceptible glow, subsequent to which the circulation is 
accelerated and perspiration induced. 

During the period of my pupilage the oil of cajeput was a very 
popular medicine in chronic rheumatism. It was taken in doses 
varying from five to twenty drops, gradually increased, and re- 
peated several times a day. The effect was often perceptible in 
the diaphoresis set up, and which generally gave relief. Some- 
times it was rubbed into the pained part morning and night, so 
as to operate as a rubefacient and counter-irritant. 



252 USES OF CALUMBO. 

Its stimulant and antispasmodic properties have been recog- 
nized in its favorable action when given for the relief of spas- 
modic colic and nervous affections generally. Rubbed smartly 
on the temples it has often relievea headache. For external 
uses it may be employed alone or mixed with a little sweet oil. 

Calcis Aqua. (See Calx.) 

Calomel. (See Hydrargyrum.) 

Calumbo. Calumba. Calumbo. Calumb. — The sliced root 
of the cocculus palmatus. It is said to be a native of Columbo, 
in Ceylon, though it comes also from Mozambique, on the eastern 
coast of Africa, where it is called calumb. 

The root is round, and hence that is the form of the slices 
which come to us in bags or sacks. These slices are said to be 
concave on both sides ; but this is not uniform, and therefore is 
not, as some have said, a test of purity. The evident shrinking 
of the slices in drying depends on the spongy quality of the 
interior portion. The best pieces have a bright color and are 
perfectly sound and very bitter, slightly pungent and aromatic. 

Brande very correctly affirms that the aqueous infusion is the 
best mode of exhibition, yet he gives the usual formula for the 
tincture, viz., an ounce of the bruised root to a pint of brandy. 
The infusion should be prepared only as it is needed, as it is 
liable to ferment in hot weather. To prepare it macerate two 
drachms of the bruised root in a half-pint of boiling water for an 
hour or two, and strain. The operation is best conducted in a 
covered earthen vessel, and a little ginger or cloves will improve 
the infusion for most purposes. 

The aromatic infusion just named is often an excellent medi- 
cine in diarrhoea and dyspepsia, and subsequently to the usual 
treatment of cholera morbus. We may add, when desirable, any 
of the alkalies or the acids, or the saline aperients or solutions 
of iron. If inflammation be wholly absent, this infusion will 
speedily allay irritation of the stomach and bowels, and a chief 
advantage is that it does not constipate. It is also highly bene- 
ficial in the troublesome sick stomach of early pregnancy, espe- 
cially if a little calcined magnesia be taken occasionally, to neu- 
tralize acid in the stomach. In the debility consequent on in- 
fantile diarrhoea much advantage is derived from the infusion 
as follows: — 

IJ. — Infusion of calumbo, (fresh,) 
Mint-water, each six drachms ; 
Carbonate of soda, a scruple. 
Mix, and give a teaspoonful every two hours to a child from eighteen months 
to three years old. 

The flatulence and heartburn of gouty persons, who have a 



USES OF CALUMBO — LIME. 253 

red deposit in the urine, is relieved by a like prescription, in- 
creasing the dose to suit the age. 

The tonic powers of calumbo are undoubted. Alone, in the 
dose of from five to twenty grains three times a day, or with 
the rust of iron and some aromatic, it accomplishes much in the 
restoration of a system debilitated by disease. The tonic pow- 
ders, as they are usually called, are prepared thus : — 

R. — Carbonate of iron, 

Powder of calumbo, each a drachm ; 

of ginger, half a drachm. 

Mix, and divide into twelve powders, one to be taken three times a day in 
water or syrup. 

Very delicate females, or others with weak stomachs, may use, 
in addition to the powders, an infusion made with cold water, as 
a common drink. Three or four slices of the root steeped in 
cold water all night will make the liquid sufficiently bitter. 

It is stated that the aqueous infusion of true calumbo strikes 
a beautiful blue-black with tincture of iodine, and does not change 
the color of a solution of the sulphate of iron. Thus it is dis- 
tinguished from the false or spurious calumbo. 

Oalumbine has been announced as the proximate principle of 
calumbo, prepared by digesting the root in sulphuric ether, 
filtering and evaporating. It possesses all the bitterness of the 
root, but is an unimportant article. 

Calx. Lime. — Oxide of Calcium, formerly called an alkaline 
earth. — Pure lime, or quicklime, is lime free of carbonic acid. 
The process of lime-burning acts so as to free limestone of its 
carbonic acid and present the lime in its pure or separate state, 
being still, however, an oxide of calcium. Oyster-shells exposed 
to a high temperature give the same result. Pure lime is caustic. 
If accidentally blown into the eyes in very fine powder it excites 
severe inflammation. In this way laborers working at the 
building of houses are often injured. The best remedy in such 
cases is the injection of sweet oil between the eyelids. The 
lime joins the oil and forms a bland liniment, which acts plea- 
santly on the inflamed mucous membrane. 

The following prescription is given by Gilbert in the London 
Lancet for August, 1843, as well suited to relieve the itching of 
porrigo, &c. : — 

Take of quicklime two drachms ; 
Carbonate of soda, 
Laudanum, each half a drachm ; 
Lard, an ounce. 
Mix well, and apply at bedtime, after washing with milk and water or soap- 
suds. 

Aqua calcis, or lime-water, is frequently a very useful article. 



254 LIME-WATER AND LINIMENT. 

It is made by adding a half-pound of fresh-made lime to twelve 
pints of water. The mixture, set aside for a few hours, presents 
a solution of the lime to as great an extent as the water can 
take up. If ten times more lime were employed the water would 
hold no more in solution. The clear liquor is to be poured off 
and kept in well-stopped bottles, to exclude the air entirely. If 
left exposed it absorbs carbonic acid from the air, which unites 
with the lime, forming an insoluble carbonate, which falls to the 
bottom. Very long exposed, every trace of lime would be lost 
to the solution, and, of course, it would cease to be lime-water. 

Lime-water is antacid, and hence much employed by dyspeptics. 
The usual dose is a tablespoonful with as much new milk, which 
improves the taste. Some suppose that lime-water acts in such 
cases, not by its antacid quality simply, but also as a feeble tonic 
and astringent. 

For the removal of uric or lithic acid deposits in the urine 
lime-water is also exhibited largely. Many regard magnesia as 
preferable ; but, in my judgment, it is better to alternate all the 
antacids than to give any one persistently, as all act, evidently, 
by neutralizing excess of acid, whatever else they may do. 

Lime-water has been found useful in various affections of the 
skin, either alone or mixed with calomel or corrosive sublimate. 
The black mercurial wash is formed by the action of calomel on 
lime-water ; the aqua phagedenica, or yellow wash, by dissolving 
corrosive sublimate in lime-water. These additions to lime-water 
are of variable strength, to suit individual cases. 

Injections of lime-water alone have been salutary in herpetic 
eruptions of the lining membrane of the nose. I knew a very 
obstinate case cured by injecting lime-water daily for three or 
four weeks. In leucorrhoea it has been employed in the same 
way. 

Linimentum calcis, or lime liniment, is a very pleasant appli- 
cation to burns and scalds. I know of nothing more grateful 
to such a state of the surface. To any quantity of lime-water 
add sweet or linseed oil until a soap is formed, shaking well all 
the while. This direction is better than the usual statement of 
quantities, which must always vary with the purity of the lime- 
water. The liniment can be applied by a feather, or spread on 
a soft thin cloth. It should be renewed two or three times 
a day, or oftener. If the liniment be well made and kept in a 
bottle with a good glass-stopper, it will retain its desirable quali- 
ties for any length of time. 

Carbonate of Lime. Creta Preparata. Prepared oyster-shells. 
Prepared crab's claws. Common chalk. — These several articles 
are, chemically, nothing more nor less than carbonate of lime. 
The prepared chalk (creta ppt.) is kept in all the drug stores, 



PREPARED CHALK. 255 

and answers well the ordinary purposes of an antacid, The fine 
powder is also called absorbent. The antacid dose is from ten to 
forty grains. It is insipid, inodorous, and nearly insoluble in 
water. 

The most agreeable form of administration of prepared chalk 
is the chalk or cretaceous julep. It is well suited to diarrhoea, 
accompanied as it often is by an acid state of the stomach and 
bowels. There is some danger of accumulation of the chalk in 
the alimentary canal, which should always be borne in mind, and 
obviated by giving an occasional cathartic. The julep is thus 
prepared : — 

Take of prepared chalk, 

White sugar, each half an ounce; 
Powdered gum Arabic, an ounce ; 
Cinnamon-water, a pint. 
Rub the solids well together, and then gradually add the water, triturating 
the whole. 

The bottle should be well shaken before the dose is given, as 
the chalk tends to subside to the bottom. If there be much pain, 
from one to three grains of sulphate of morphia may be added. 
The adult dose is a tablespoonful every hour or every two hours. 

The above quantity of the cretaceous julep is too large to be 
prepared at once in warm weather, as it is liable to ferment 
unless kept in a cold place. 

Chloride of lime is an article of more recent date than the 
carbonate, but is extensively employed. It is, chemically, a 
chloride of an oxide, or chlorine combined with lime, or oxide of 
calcium. It is made by passing chlorine gas freely into diluted 
slacked lime. The strength of the chloride depends on the quan- 
tity of chlorine gas it contains. The bleachers, who employ it 
very largely, can tell pretty accurately what the strength of the 
article is by the taste. It is called by them bleaching salt. A 
more accurate method is to ascertain its power to bleach a solu- 
tion of indigo. 

The disinfecting power of chloride of lime is now acknowledged 
all the world over. It stands first on the list of disinfectants, 
and deservedly so. Chlorine steadily escaping from it neu- 
tralizes offending gas. On this principle I have advised it to 
be washed over newly plastered walls that were offensive in con- 
sequence of foul hair mixed with the lime. The expedient was 
speedily effectual. The walls of dissecting-rooms and privies 
are thus treated in order to subdue foul odors ; and the chloride 
scattered about in rooms or thrown into pits will soon exert a 
correcting influence. So, likewise, when hospitals or infected dis- 
tricts are desired to be purified as far as practicable, chloride of 
lime is freely spread about, and the result is obvious. During 



256 CHLORIDE OF LIME A DISINFECTANT. 

the prevalence of Asiatic cholera in Philadelphia, in 1849, the 
vapor issuing from the sewers was exceedingly offensive, but the 
application of the chloride freely at the opening so corrected 
the exhalation that its unwelcome effluvia were no longer per- 
ceived. 

"Christison, in his work on toxicology, says: — 'It is an in- 
teresting fact, that during the epidemic fever which raged over 
Ireland, from 1816 to 1819, the people of the bleaching manu- 
factory at Belfast were exempt from it.' A strong fact, when 
we consider the length of time, &c. 

" Desgenettes, the celebrated surgeon, gives, in a letter to the 
'Institute,' presented by Cuvier, the following strong evidence of 
the disinfecting powers of chlorine. After stating that he had 
continually used chlorine fumigations in the military hospital of 
Paris for the space of one year, he adds : — ' The houses of mili- 
tary arrest in this capital regularly furnish to the military 
hospital cases of adynamic fevers, which were not only aggra- 
vated in our wards, but were communicated, very frequently, to 
the patients in the neighboring beds and to the attendants. It 
is certain that, for the space of a year, these communications 
have not taken place. Very extensive gangrenes among the 
wounded have also been limited to the unfortunates who were 
first attacked,' &c. &c. 

"In Johnson's Medic o-Ghirurgical Review for 1828, p. 458, is 
an interesting report of the surgeon of the Windsor Castle East 
Indiaman, Mr. Docker, on the virtues of the solution of chloride 
of lime : — ' During their stay at Sangur Island, in the mouth of 
the Ganges, the gun-deck was regularly sprinkled, morning and 
evening, with the solution. The consequence, he thinks, was a 
comparative immunity from cholera, which was raging fatally in 
the other ships. The wind blew from the shore all the time and 
was loaded with morbific miasmata. In China they used the 
chloride and escaped the dysentery, which prevailed in the river 
Tigris at the time,' &c. &c. 

"In an article in the London Lancet, (1831-2, vol. i. p. 598,) 
prepared by its very logical editor to disprove the anti-pestilen- 
tial properties of chlorine, are to be found the following very 
satisfactory experiments, which were performed in London, viz. : 
' Smallpox matter, both on glass and on linen cloth, was pro- 
cured from the smallpox hospital. This was divided into two 
parcels, one of which, No. 1, was immersed for three hours in a 
vessel containing one volume of chlorine gas and twenty-four of 
atmospheric air. The other, No. 2, was immersed for the same 
time in a vessel in which there was only one-fiftieth volume of 
chlorine gas. This process was conducted by Mr. Faraday; 
with No. 1 the following trials were made : with the point of a 



EXPERIMENTS OF FARADAY. 257 

lancet three long scratches were made on the arm of a child so 
as to draw blood ; a piece of the linen cloth, having still adhering 
to it much of the matter in which it had been soaked, was placed 
over the wounds and bound to the arm by a strap of adhesive 
plaster. Two other persons were inoculated in the usual man- 
ner in six places with the matter on glasses, which was previously 
scraped together into a small heap and moistened with a little 
water. All these failed to produce any disease. With No. 2, 
four individuals were inoculated with the same matter, in three 
places in each arm, with no other effect than a slight degree of 
inflammation around some of the punctures. All these seven 
persons have since been vaccinated, and have had the disease in 
the most perfect and regular way, thus showing their suscepti- 
bility to have taken the smallpox had not the virus been deprived 
of its contagious quality by the influence of the chlorine. An- 
other supply of smallpox matter was obtained from the smallpox 
hospital, part of which was exposed for three hours, by Mr. Fara- 
day, to diluted chlorine gas in the proportion of one volume in 
a hundred of atmospheric air ; with this matter two children 
were inoculated in three places on each arm without any effect ; 
both of these children were afterward vaccinated, and had the 
disease in a perfect manner.' 

" The known accuracy of Mr. Faraday as an experimenter 
gives great force to facts, to which all the known ingenuity of 
the editor of the London Lancet can only oppose some plausible 
objections. 

" Mr. Cruikshank, another accurate observer, reports that he 
tried, without effect, on two subjects, a portion of varioloid virus 
which had been exposed to chlorine, another portion of which 
not previously exposed to the gas produced the variolous erup- 
tions. 

" In regard to scarlet fever, although many quotations might 
be given as to its utility in preventing its spread among the in- 
mates of a house, I will content myself with giving the authority 
of Dr. Watson, of London, as to its great value in the treatment 
of some of the worst forms of this disease. After describing 
the mode of using the compound and the good effects resulting, 
he says : — ' From several distinct and highly respectable sources 
chlorine itself has been pressed upon my notice as a most valu- 
able remedy in the severest forms of scarlet fever. My inform- 
ants have stated, that whereas they formerly dreaded to be called 
to cases of that disease, they now, having had experience of the 
virtues of chlorine, felt no misgivings in undertaking its treat- 
ment.' Stating that he had not as yet tried the pure chlorine suffi- 
ciently to give a positive opinion, he adds, ' I presume that its 
disinfecting properties may, in part, account for the good it 



258 DISINFECTING POWER OF THE CHLORINE. 

does. It probably deprives the foul secretions of their noxious 
quality.' 

" Other diseases regarded as contagious are successfully 
treated by the chlorine compound, as scabies, tinea capitis, &c. ; 
and those who raise silkworms find that chloride of lime placed 
in dishes throughout the rooms in which the worms are fed is a 
perfect remedy against the infectious diseases of those insects 
which arise when they are much crowded together, and which 
formerly threatened seriously to injure the business of raising 
silk. 

"It is a great misfortune that the chlorine compounds are too 
much neglected by the profession generally ; and this neglect is 
in part owing to the unjust doubts raised by the time-serving 
medical journalists and scissors authors of Europe, as well as to 
the influence of fashion in physic. 

" In answer to objections to the odor, and the irritating effects 
of chlorine evolved from chloride of lime in small quantities, I 
will add a few facts. 

" 1. I have often been freely exposed to it without any incon- 
venience, and the workmen in the chloride of lime manufactories, 
who are exposed to considerable quantities of the air, get ac- 
customed to it and experience no injury. 

"2. Chlorine fumigations were employed in the great Found- 
ling Hospital of Paris without the slightest inconvenience to 
either infants or nurses. [Ann. de Chim. t. li.] 

" 3. Berthollet, Halle, and Vauquelin, well known as accurate 
observers, reported to the French Institute as follows in regard 
to the use of chlorine on the vessels of the fleet of Napoleon in 
the expedition to Egypt : — ' According to the directions of the 
Committee of Public Health, we daily fumigated the ship 
27 Orient with chlorine, and no one complained of the least in- 
convenience.' It is remarkable that the whole fleet submitted to 
the same regimen, and made its passage with scarcely any dis- 
ease, although crowded with soldiers. The same was the fact in 
the frigates which accompanied the First Consul." 

The quotations just made are taken from an article published 
by Professor Peter, in the Observer and Reporter, of Lexington, 
Kentucky. 

In addition to the above the following facts, being decidedly 
practical, will enforce the doctrine contended for. Two medical 
pupils who came to Lexington, Ky., early in November, 1842, 
to attend medical lectures, sickened during the week appropriated 
to introductories. They lodged in a small chamber, with two 
other young men, and in a house containing over twenty boarders. 
The one was seized with a fever pronounced to be typhoid, and 
contagious ; the other had an eruption, having the appearance of 



MEDICINAL USES. 259 

the varioloid disease. The latter was a practitioner, of about 
thirty-five years of age, had never seen smallpox, and showed a 
scar on his arm to prove that he had been vaccinated. His case 
was narrowly watched and soon proved to be confluent smallpox; 
and now the consternation in the medical class, numbering over 
two hundred and fifty, was very great. Some of them directly, 
and all indirectly, had been exposed, as they thought, to two 
contagious diseases. The typhoid fever man dreaded lest he 
should be infected by his room-mate, who, in turn, feared the 
contagious quality of typhoid poison. But, having watched 
these cases from the first, I directed the profuse employment of 
the chloride throughout the chamber .and house. The man with 
smallpox assured me that he was sleeping in chloride of lime, and 
so it really appeared. 

To allay the fears of the class a great many pupils were vac- 
cinated, and all were prevailed on to remain in the city. The 
result of the whole affair was the recovery of both patients, and 
there the matter ended. Not a case of smallpox occurred in the 
neighborhood, nor in the city, save that of the medical student. 

Our next object will be to set forth some of the numerous 
therapeutic uses of the chloride of lime, remarking as we pro- 
ceed that the profession is by no means properly instructed in 
this matter. This compound is of very great value as a remedial 
agent. 

The external uses have been very numerous, and, from its dis- 
infecting and cleansing properties, when applied to the diseased 
surface, more benefit may be expected than from any other ex- 
ternal application. In itch, herpetic affections, burns, &c, it 
has been employed in large hospitals and in private practice very 
successfully. An ounce of the chloride dissolved in a quart of 
water makes a solution proper for this purpose. It should be 
applied several times a day for at least a week. The hand or 
foot may be immersed in the bath for ten minutes at a time. 
Besides the external use, in skin diseases a weak solution has 
been at the same time taken internally, where the cutaneous 
disease had a scrofulous modification. For this end fifteen parts 
of the chloride are dissolved in five hundred parts of pure water, 
and of the solution a tablespoonful is taken three times a day in 
a bitter infusion, as quassia or chamomile. 

Lisfranc treated burns and chilblains with soft lint soaked in 
a strong watery solution of the chloride, covering the whole with 
a wax cloth. Dr. Chopin lauds a solution of the chloride in 
warm water, as an application to wounds from surgical operations 
or accidents, with a view to assuaging pain. 

Ulceration of the gums, emitting an offensive odor and slow 



260 MEDICINAL USES OP THE CHLORINE. 

to heal, have been greatly improved by use of the following 
mixture : — 

$. — Chloride of lime, fifteen grains ; 
Mucilage gum Arabic, an ounce ; 
Syrup of lemons, half an ounce. 
Mix, and apply on soft lint two or three times a day. 

To lessen exquisite cutaneous sensibility of the skin, Sir Ben- 
jamin Brodie employed a lotion of two or three grains of the 
chloride, dissolved in an ounce of alcohol, three or four times a 
day. It hardens and thickens the cuticle and blunts the sensi- 
bility. (See Ranking s Abstract, vol. ii. No. 2, p. 123.) 

Besides a watery solution, an ointment or pomatum has been 
successfully used in the treatment of itch, as we learn from the 
Bulletin GSneral de Therapeutique for 1828. Dr. Emery gives 
the following prescription : — 

]J. — Brown soap, an ounce ; 

Common salt, half an ounce ; 
Flowers of sulphur, half an ounce ; 
Alcohol, 

Vinegar, each two drachms ; 
Chloride of lime, a drachm. 
Mix, and apply freely to the parts affected, night and morning, using smart 
friction. 

In the Udpital St. Louis twelve hundred persons were cured, 
some in four days, and none requiring longer time than fourteen 
days. The remedy does not soil the clothes, -has no bad smell, 
and is cheap. 

The pruritus of the genital organs in both sexes is often 
promptly relieved by the application of a solution of the chloride 
night and morning. But this and all external applications will 
often signally fail unless the proper means be taken to correct 
the digestive organs. 

The internal exhibition of the chloride of lime is more ne- 
glected than its external use. Here it acts partly by correcting 
the foul quality of the intestinal discharges and by its stimulant 
action, whereby it seems to counteract the fatal tendency of the 
typhoid element that so sadly depresses the system. In dysen- 
tery and in low fevers the remedy has been singularly serviceable 
in Europe and in this country. 

Dr. Bead, of Dublin, speaks very favorably of the following 
mixture : — 

R. — Chloride of lime, ten grains; 

Infusion of calumbo, two ounces ; 
Water, four ounces ; 
Simple syrup, two drachms. 
Mix, and give a tablespoonful every hour, and employ an injection of the 
chloride at the same time. 



HYDROCHLjDRATE OF LIME — GAMBOGE. 261 

The obvious effects of the remedy were to control the dis- 
agreeable fetor of the discharges from the bowels, and by its 
gently stimulant action to check delirium and subsultus ten- 
dinum. The tongue is improved, the skin moistened, and the 
whole condition made better. 

Mr. Groeffe, of Berlin, gave the chloride in Menorrhagia or 
gonorrhoea, and sometimes in gleets. He administered it' in the 
form of pill and by injection. 

Hydro chlorate, or muriate of lime. — -Readily made by dissolv- 
ing carbonate of lime in hydrochloric acid. The solution is of a 
light yellow color, inodorous, but of a slightly bitterish acrid 
taste. The dried muriate, exposed to a strong heat, yields chlo- 
ride of calcium. 

The late Dr. Beddoes was very partial to this medicine in the 
treatment of scrofula, and it is sometimes employed at present 
in that disease in connection with the external use of iodine. 
The adult dose of the solution is from ten to thirty drops three 
times a day in infusion of calumbo, or chamomile, or quassia. 
The continued exhibition for some weeks proves decidedly alter- 
ative, though a tonic power has more commonly been ascribed 
to it. 

Dr. Somervail, of Virginia, reports successful use of the muri- 
ate of lime in palsy of the lower extremities. He gave twenty 
drops every two hours for a month, aided by some local appliances 
in the nature of counter-irritants. 

An ointment of the muriate has been favorably spoken of in 
the treatment of chilblains in a state of ulceration. The oint- 
ment is soothing, and promotes the healing process. 

Sulphuret of lime, made by heating and stirring for the 'space 
of fifteen minutes a mixture of equal parts of quicklime and 
flowers of sulphur, has been much employed as a remedy for itch, 
in the shape of a lotion which should be made pretty strong. 
Half an ounce to a pint of water may be tried at first, and ap- 
plied night and morning. An ointment made of one part of the 
sulphuret and eight parts of lard has been suggested by Dr. 
Savardin for the relief of old tetter. He directs smart friction 
to be employed for ten minutes with the palm of the hand, or a 
soft flannel, morning and evening. 

Dr. Beneke, of London, Dr. Stone, of New Orleans, and 
others, have fancied that good results attended the use of phos- 
phate of lime in pulmonary phthisis, scrofula, &c. &c. They 
suppose it aids in renewing air-cells destroyed by long disease. 
There is not sufficient testimony on this point. 

Cambogia. Gamboge. — Gum-resin of the Stalagmitis cambo- 
giodes. From Kamboge, a river in Siam, on whose banks the 
tree grows. 



262 GAMBOGE, ITS PROPERTIES. 

Incision into the bark of the tree causes a free exudation of 
its juices, which, being collected and gradually inspissated, yields 
large masses of the article. It is imported chiefly from Ceylon, 
in casks, well covered with flag-leaves. Some of the books have 
a good deal to say of spurious kinds of gamboge, and consume 
much more space than its therapeutic merits justify. I will not 
imitate their example. 

In the practice of physic gamboge is held to be a drastic, hy- 
dragogue cathartic, by which terms we mean that it operates 
smartly on the bowels, causing more or less gastric pain and 
sickness, and giving copious watery stools. This latter pro- 
perty has long been known, and has caused it to be made a 
constituent in many empirical remedies for the cure of dropsical 
affections. 

Gamboge has also been exhibited in connection with calomel, 
for the relief of torpor of the bowels, in the proportion of two or 
three grains to ten of calomel, to be taken once in four hours. 
It is sometimes a very good medicine in cases of dysmenorrhoea, 
which, however, is a disease of multifarious peculiarities that call 
for special notice. The following combination is serviceable 
where there is decided torpor of the bowels and a high degree of 
nervous uneasiness at the same time : — 

R. — Powder of gamboge, 

aloes, 

Fetid gum, each a drachm. 
Incorporate these well with the help of mucilage of gum Arabic, and divide 
into sixty pills. The dose is one or two three times a day, or two at bedtime. 

When the dysmenorrhea is associated with habitual costive- 
ness, or when the latter exists independently of the former, gam- 
boge combined with sulphate of quinine has proved a useful medi- 
cine. Dr. Chevallier gives the following formula in the London 
Medical Gazette for 1834, as suited to cases where the consti- 
tutional debility is of long continuance and the bowels evidently 
suffering from loss of tone : — 

B=. — Sulphate of quinine, twenty-four grains ; 
Compound gamboge pill, thirty-six grains ; 
(Or fifteen grains of gamboge.) 
Mix, to make twelve pills, and take one three times a day. 

For the relief of dropsy, by inducing copious watery dis- 
charges, a mixture of six grains of gamboge in four ounces of 
water, holding in solution two drachms of carbonate of potash, 
has long been in successful use. The adult dose is a tablespoon- 
ful every hour. The diuretic effect is decidedly increased by the 
addition of cremor tartar and squills. 

Gamboge has had some reputation as an anthelmintic, espe- 



CAMPHOR. 263 

ciaily for the destruction of tapeworm, but it is more than pro- 
bable that the result depends on the drastic cathartic action of 
the medicine. 

The fine powder of gamboge has been found to operate on the 
bowels promptly and efficiently when laid on an ulcerated surface. 
From five to ten grains will suffice. It is a very satisfactory in- 
stance of endermic medication. 

Camphor. Camphire. — The product of the Laurus cam- 
phora. Not a gum, but a concrete volatile oil. Other plants 
besides the Laurus camphora contain camphor, as the spice-wood, 
sassafras, &c. When first obtained from the vegetable source 
the article is impure, being of a gray color and evidently blended 
with foreign matters. The strong smell of a chest made of cam- 
phor-wood, and which adheres to it for an almost unlimited 
period, shows that the vegetable substance contains a volatile 
ingredient in considerable quantity. This is separated by a kind 
of distillation, and is collected in large quantities. The crude 
camphor, as the imported article is usually termed, is purified or 
refined by mixture with quicklime and exposure to a sand-bath 
heat in glass vessels loosely closed at the mouth with carded 
cotton so as to prevent the escape of vapors and prevent explo- 
sion. The lime joins the foreign matter, while the pure camphor 
rises and is condensed on the upper surface of the vessels. The 
refined camphor, which is easily detached by fracture of the ves- 
sels, is of a whitish color, translucent, rather tough, having the 
strong camphor smell, and not reducible to fine powder unless a few 
drops of alcohol be added. The smell of camphor is very pecu- 
liar, exceedingly penetrating, and certainly fatal to moths ; and 
hence the preservation of woollen goods or clothing by the addi- 
tion of some lumps of camphor. The volatility of the article 
suggests that it should not be broken into small pieces. I have 
known fragments an inch and a half square to disappear almost 
entirely in one season. 

The oil of camphor is named in some of the books as a new 
article. But it is quite certain that something of the kind has 
long been known. The oil of commerce is very generally a 
fraudulent article, but, even if always pure, it is not likely to 
come into general use. 

Camphor has a taste combining pungency with a sense of cool- 
ing. It is decidely aromatic, and, to most persons, grateful. 

We have said that it is not a gum, and this is evident from the 
failure of water to act upon it. Even trituration of camphor in 
water will hardly dissolve any portion, though the fluid is sensi- 
bly impregnated with the odor. If water be charged with car- 
bonic acid gas, as in shape of seltzer-water, it will dissolve more 
than pure water. Alcohol and acetic acid make energetic solu- 



264 THERAPEUTIC PROPERTIES OF CAMPHOR. 

tions. The bisulphuret of carbon dissolves camphor readily, but 
the solution speedily evaporates. If we add magnesia to cam- 
phor, and triturate with water, we thus dissolve a larger quantity 
of camphor than the water singly could take up. The term tinc- 
ture or spirit of camphor is applied to the alcoholic solution, 
while the product obtained by the solvent power of acetic acid 
is called the acetic solution of camphor. If water be added 
to either of these solutions the camphor is detached or preci- 
pitated. 

Camphor has been called stimulant , expectorant, anti-peri- 
odic, anodyne, discutient, &c. &c. In very large doses it is 
poisonous. 

Few medicines have been administered internally with less ra- 
tional views than camphor. Many have employed it solely be- 
cause others had given it before, and they could hardly tell why 
they gave it as a remedy or what end they hoped to accomplish 
by it. Still it must be conceded that camphor is sometimes a 
useful medicine. 

During the prevalence of Asiatic cholera in 1832, in Cincin- 
nati, and in 1849, in Philadelphia, camphor was frequently car- 
ried in the pocket, and a small fragment of the size of a pea 
swallowed two or three times a day as a sort of safeguard. The 
habit was a good one. It kept the mind in a state of compara- 
tive quietude, and every day's immunity increased confidence in 
the preventive. The man relied on his pocket-companion, and 
allowed his stomach and bowels to escape the shocks too often 
inflicted by stimulants and astringents unnecessarily taken by 
many who were constantly under the influence of terror. 

Experience has taught that camphor will sometimes induce 
sweet sleep if conjoined with opium, where the latter by itself 
has failed. I have witnessed this result again and again. The 
usual proportion for an adult is two or three grains to one of 
opium, made into a pill. Besides the anodyne effect we fre- 
quently have an obvious diaphoresis that is decidedly favorable. 

Raspail affirms that when opium and all the vegetable narco- 
tics fail to stop that fearful insomnolence which marks the first 
development of insanity, a grain of camphor given in pill, and 
followed by an ounce and a half of hop infusion, with five drops 
of sulphuric ether, will procure sleep. 

Camphor is sometimes a good adjunct to Peruvian bark, sul- 
phate of quinine, volatile alkali, and the fetid gum, enabling 
them to perform their peculiar therapeutic functions better than 
when given alone. It is also very happily compounded with 
Dover's powder, in the course of low fevers, where a gentle 
stimulus is needed, whose ultimate effect may be to induce a 



PREPARATIONS OF CAMPHOR. 265 

salutary diaphoresis ; for this end two grains of camphor may be 
added to ten of the powder. 

Irritability of stomach was often relieved by Cullen by the 
use of the acetic solution of camphor given internally. And one 
of the most popular medicines for Asiatic cholera, in which there 
is often terrible gastric irritability, was the camphorated mixture 
usually called ParrisKs mixture. The camphorated aromatic 
water is essentially of the same nature, and is an excellent medi- 
cine for irritable stomachs after free vomiting. It may be made 
by triturating camphor and calcined magnesia with the compound 
spirits of lavender and water, and then filtering. A considerable 
quantity of the camphor is held in solution, which, aided by the 
spirit of lavender, exerts a happy influence. It may be made 
thus : — 

R. — Camphor, a drachm; 

Calcined magnesia, two drachms. 
Make the camphor as fine as possible by rubbing -with it from fire to ten 
drops of alcohol; then triturate the magnesia with it. Then add two ounces of 
the compound spirit of lavender, rubbing the whole together, and next add 
eight ounces of water. Mix and filter. 

The dose of this mixture is a tablespoonful, taken every hour 
or oftener, according to the severity of the case. 

The following mixture is a little different in form, but sub- 
stantially the same in effect : — 

R. — Camphor, a drachm; 

Calcined magnesia, two drachms ; 

White sugar, 

Powdered gum Arabic, each a drachm and a half; 

Oil of lavender, twenty drops ; 

Water, a pint. 

Rub the solids well together, add the oil, and triturate, finally adding the 
water. 

The mixture may be used thus or be first filtered. A table- 
spoonful may be given every two hours for the relief of flatulent 
pains, with sick stomach. 

The camphorated julep, to which some physicians are partial 
in the management of low fevers, is made thus : — 

R. — Camphor, a drachm; 
Powdered gum Arabic, 
White sugar, each half an ounce ; 
Mint or cinnamon water, six ounces. 
Mix the solids well, and add the water. 

Dose, a tablespoonful every half-hour or less frequently, as the 
case may demand. The quantity of gum Arabic is purposely 
large, and is intended to act as a demulcent in reference to an 
irritable state of the bowels, often present in low fevers. 

The simplest form of camphorated mixture for medicinal pur- 

18 



266 EXTERNAL USES OF CAMPHOR. 

poses is prepared by digesting a drachm of pulverized camphor 
in a pint of boiling water for two hours in a tight vessel. From 
what was formerly said, none of the camphor can be thus dis- 
solved, yet it was believed that the mixture, even after filtration, 
was decidedly stimulant in tablespoonful doses. In a very ex- 
citable state of the system it is quite probable this effect might 
be realized, and subsequently a diaphoretic operation. 

As most of the prescriptions for diarrhoeas and cholerine 
seizures that are often almost epidemic contain camphor, we 
may fitly introduce in this place a formula employed with very 
great success by my son in the navy, and furnished to him by 
Dr. Sharp, Fleet Surgeon on the West Indian station, in 1850, 
who reported almost invariable success : — 

IJ. — Aquae camphorat. ^iij ; 
Tinct. op. camph. 
Spt. lavend. 
Ether sulph. aa ^ss ; 
Alum sulph. gss ; 
Sacch. alb. 3jij. 

Give a tablespoonful after each evacuation. Sometimes, to the above were 
added two drachms of tincture of capsicum. 

In the eighth volume of the Edinburgh Medical and Surgical 
Journal, Dr. Cassils proposes milk for camphor mixture in lieu 
of other solvents. He directs a milk emulsion of camphor to be 
made by rubbing well together a half-drachm of pulverized cam- 
phor, four ounces of milk, and seven and a half ounces of water. 
He affirms that none of the camphor is precipitated. He insists 
also on the propriety of taking milk, in lieu of brandy, to make 
the camphorated tincture of opium. He says a better pectoral 
is thus obtained. 

The antiperiodic property of camphor is not now insisted on. 
In the days of Professor Halle it was administered, in combina- 
tion with the nitrate of potash, in the period of intermission, and 
prevented a repetition of the paroxysm. 

Dr. Wilson, of Mansfield, in England, gave camphor in thirty- 
grain doses to a boy laboring under epilepsy, with marked benefit. 
To a girl, aged fifteen, affected with chorea, he gave eighteen- 
grain doses four times a day, and cured her. This was in 1786, 
and would now be regarded as bold practice. We copy these 
facts from Medical Commentaries, vol. vi. 

The external uses of camphor are important. Sometimes it 
acts as a discutient, as when it is combined with mercurial oint- 
ment, in the treatment of enlarged testicle after depletion, in 
the proportion of two drachms of camphor to an ounce of the 
ointment, well incorporated, and applied night and morning. 
The acetic solution, made by adding an ounce of camphor to a 



POISONOUS ACTION OF CAMPHOR. 267 

pint of acetic acid, is also discutient. Cream rubbed with the 
powder of camphor makes an excellent ointment or pomatum, 
which acts in the same way. 

Various forms and grades of rheumatism have been treated 
successfully by the external use of camphor. In the American 
Journal of Medical Sciences for 1838, we find a case of chronic 
rheumatism of the thighs and legs, accompanied with severe 
pain, cured by camphor fumes. The camphor was placed on a 
heated iron plate, over which the patient was seated, covered 
with a blanket. A half-ounce of camphor was consumed at 
each operation, which had to be repeated three or four times. 
A most copious sweat was brought out, which afforded prompt 
relief. 

Dr. Ferriar, in his Medical Histories, speaks in high terms of 
a camphorated liniment as a remedy for lumbago. . It is made 
thus: — 

R. — Camphor, two drachms ; 

Basilicon ointment, an ounce ; 
Black soap, half an ounce. 

Mix, and apply to the part two or three times a day, with smart friction. A 
scruple or two of the flour of mustard augments the power of the mixture. 

The same physician also employed a solution of camphor in 
sulphuric ether as a lotion to parts affected with rheumatic pains, 
and occasionally a camphor poultice,- made by sprinkling over a 
bread and milk poultice twenty or thirty grains of the fine pow- 
der of camphor. 

Incontinence of urine has been completely cured in a woman, 
aged forty, by an injection consisting of four grains of camphor 
suspended in warm water with the yolk of an egg. It was re- 
peated every night, and occasionally two or three times a day, 
for two weeks. (See Banking's Abstract, No. vi. p. 209.) 

Distressing pruritus of the genital organs, a very embarrassing 
affair, is sometimes checked by dusting on the parts two or three 
times a day a mixture of one grain of fine camphor powder and 
five grains of starch. 

The poisonous action of camphor has never, so far as I am 
aware, terminated fatally. A man took one hundred and sixty 
grains by mistake, and, being seventy-four years old, the case 
was deemed rather a doubtful one. Very intense gastric heat, 
severe headache, indistinctness of vision, redness of the face, a 
full and hard pulse, were all the consequences ; and these were 
met so favorably by almond emulsion and a mixture of equal 
parts of vinegar and mucilage of gum Arabic that a very copious 
sweat broke out and recovery ensued. 

Two-drachm doses have induced high cerebral action and gene- 
ral morbid excitement, elevating the pulse to 180, and deeply 



268 POISONOUS ACTION OP CAMPHOR. 

suffusing the eyes and face. The free use of emetics, followed 
with opiates, effected a cure. (See British and American Jour- 
nal of Medical Sciences.) 

The London Medical and Physical Journal, vol. i. p. 510, 
gives the case of a man who took ten pounds and a half of cam- 
phor in twenty-two days for the cure of smallpox ; and, says 
the writer, "he died notwithstanding." What a wonderful con- 
cession ! 

Mr. Kingdom, in November, 1842, related to the Medical 
Society of London the case of a gentleman who swallowed by 
mistake a considerable quantity of the compound tincture of 
camphor. The first effect was a burning pain in the lower lip, 
which spread down the oesophagus, and eventually over the whole 
surface of the body. The symptoms were removed completely 
by the free use of emetics. 

Another case was detailed by Mr. Clarke, in which the occa- 
sional swallowing of very small portions of camphor induced 
giddiness, and finally epileptic symptoms. When roused, the 
patient could scarcely articulate, being in a kind of half coma- 
tose condition. The stomach-pump drew out a quantity of fluid 
strongly impregnated with camphor. As the system exhibited 
signs of great exhaustion, external and internal stimulants were 
resorted to and continued for three hours. After this he had 
occasional suppression of urine for three months, and was finally 
cured by the use of gentle cathartics and saline remedies. — 
London Lancet, Nov. 1842. 

Two short articles in the July number (1857) of the London 
Lancet seem to render it probable that in certain persons cam- 
phor may induce a disease very much like epilepsy. One case 
is that of a female in whom only twenty drops of the spirit of 
camphor, repeated every three hours, brought on vertigo, im- 
paired vision, and insensibility, with foaming at the mouth, 
twitchings of the muscles, &c. The fit lasted about six minutes, 
and on awakening she was unconscious of what had passed. She 
remembered, however, that about eleven years previous the same 
train of symptoms ensued from eating a piece of camphor of the 
size of a nutmeg. 

The other case is that of a young lady who was playing with 
a piece of camphor of the size of a marble, which was incautiously 
swallowed. She stated that two of her sisters had suffered from 
epilepsy as a consequence of eating camphor. 

After all that has been or can be said, the action of poisonous 
articles is relative, and must be so from the nature of the case. 
Hence ten grains of camphor might do considerable injury to a 
man at one time and in a special condition who could swallow 
twice as much without harm under other circumstances. Even 






USES OF INDIAN HEMP. 269 

the ordinary adult dose of five grains has sometimes affected the 
stomach unpleasantly. 

Cannabis Indica. Indian Hemp. — This article is introduced 
here for two reasons. It has attracted a good deal of attention 
in this country as well as in Europe; and it is important that 
our own hemp should be properly investigated in order to de- 
termine what medicinal powers it may develop. 

The resinous exudation from the leaves of the foreign hemp 
is the part collected and sold under the name of churrus ; some- 
times denominated the resinous extract of hemp. In Central 
India, men clad in leather dresses run through the hemp-fielcls, 
brushing through with all possible violence. The soft resinous 
matter adheres to their dress, is subsequently scraped off and 
kneaded into balls. 

Galen speaks of hemp seeds as promoting hilarity and enjoy- 
ment. The smoking of the leaves is said to induce intoxication, 
which lasts for about three hours, after which sleep comes on 
without subsequent nausea or sickness of stomach, as is generally 
the case after over-stimulation by alcohol. 

The resinous extract has some resemblance to opium in point 
of color, though it lacks the peculiar taste and smell. 

The prominent therapeutic property assigned to this medicine 
is that of anti-convulsive, a new term, which perhaps could well 
be dispensed with. I suppose the old word anti-spasmodic has 
pretty much the same meaning. It is said that no serious con- 
sequences need be apprehended from a large dose. It does not 
constipate nor induce any of the unpleasant effects of opium. 
Dr. O'Shaughnessy, who has paid special attention to this arti- 
cle, says it is well suited to tetanus, and his views are confirmed 
by the editors of the Provincial Medical and Surgical Journal 
of Dublin. Braithwaite s Retrospect, part vi., the American 
Journal of Medical Sciences for July, 1843, and London Lancet 
for May, 1843, contain full information on this subject. 

In the Boston Medical and Surgical Journal for June, 1846, 
the late Dr. Isaac Heister, of Reading, Penn., reported a case 
of tetanus successfully treated. He gave the extract in solution, 
in teaspoonful doses, containing two grains, which were repeated 
every hour until the spasms were controlled and sleep obtained. 
After the fourth dose the patient slept nearly two hours. The 
spasms returning, five-grain doses were administered, and re- 
covery soon took place. 

The ordinary dose of the resin has been five grains, to be 
repeated every hour or two, according to the urgency of the 
symptoms. The tincture in djoses of from twenty to thirty drops 
has been successfully exhibited in uterine hemorrhage. 

Dr. Mitchell, of Dublin, regarding the Indian hemp as a de- 



270 SPANISH AND AMERICAN FLIES. 

cided anti-hemorrhagic medicine, administers it for the arrest 
of Menorrhagia. He employs the resinous tincture in ten-drop 
doses, repeated every four hours; and says he has known a 
single dose to cheek a discharge that had resisted all ordinary 
means for months. In the debilitating dribbling from the womb, 
so annoying to some pregnant women, he says it is equally effica- 
cious. (See Dublin Medical Press, Oct. 1847.) Dr. Churchill 
and others have succeeded with five-drop doses three times a 
day. It is believed to act partly as a sedative and partly as an 
astringent. (See Banking's Abstract, No. 10, page 267.) 

It is proper to say that some physicians who profess to have 
had considerable experience in the use of this medicine think it 
has been very much overrated. I have never employed it, and 
think it demands further and more extended trial to test its true 
value. 

Cantharldes. Oantharis Officinalis. Lytta Vesicatoria, or 
Blister Beetles, or Spanish Fly. Lytta Vittata, or American 
Fly. — The Spanish fly is of a brilliant green, and when perfect 
and sound is entirely free of worm-holes, has an acrid, burning 
taste, and evolves rather a nauseous odor. The flies are said 
not to live over eight or ten days, and during life they are 
readily detected by the exceedingly fetid odor they exhale. 
They are caught early in the day by striking them from the 
trees and plunging them into vinegar, which kills them. They 
are afterward to be dried perfectly in the sun or in heated apart- 
ments. Their preservation in a sound state demands a good deal 
of care ; which, being properly given, they will retain their pecu- 
liar properties for thirty years. Notwithstanding their violent 
action on the human tissues they are subject to the depredations 
of other insects, which destroy the soft organs of the fly and 
render it worthless. They should be kept in well-stopped bottles, 
covered with bladder or leather, or both; and a small quantity 
of pyroligneous acid, or camphor, or chloride of lime, should be 
put in each bottle. 

The Spanish fly abounds in the south of France, Spain, and 
Italy, and is found on the ash, lilac, privet, elder, honeysuckle, 
plum, willow, and elm-trees. The warmer the region the more 
energetic are the flies. 

The American fly is rather smaller than the Spanish fly, and 
of a much darker color. It abounds in particular seasons on 
potato vines, beet leaves, and other vegetation. In the summer 
of 1841, while residing near to Lexington, in Kentucky, I could 
have collected bushels of them from the potato and sugar-beet 
patches. They completely destroyed the leaf structure, with 
the exception merely of the fibrous skeleton. This fly was first 
noticed in 1800, by Dr. Isaac Chapman, of Bucks county, Pa., 



PLASTER OF CANTHARIDES. 271 

who published a paper respecting it in the New York Medical 
Repository. During the last war with Great Britain, when the 
foreign fly could not be obtained excepting at very high prices, 
the American fly was employed as a substitute with great success. 
I have used it externally and internally, and with the same results 
as are usually had from the Spanish fly. 

The therapeutic uses of the fly are various. It is, externally, 
an irritant, rubefacient, vesicant; internally, a counter-irritant, 
a diuretic, a narcotic, and an acrid poison. 

Various modes are pursued to get the irritant, rubefacient, and 
vesicant effects. I believe that the proximate principle, cantha- 
ridin, or oil of cantharidin, as it is often improperly called, is 
the neatest application to accomplish either of these ends. For 
children and delicate persons it is far preferable to all other 
forms. It is neat, cleanly, effective, and rarely followed by 
strangury. A piece of white paper soaked with the cantharidin, 
which is greenish and liquid, will answer the purpose effectively. 
This is laid on the part, covered with a compress, and confined 
by means of a bandage. From three to five hours generally 
suffice to insure vesication. 

The pad blister is probably, when judiciously managed, the 
neatest form next to the cantharidin paper. This may be made 
of any desirable size by cutting pieces of cotton, or linen, or 
flannel of various dimensions, and quilting between several layers 
a portion of good powdered flies. The edges may be bound with 
silk or otherwise, to give a neat appearance. For use, the pad is 
dipped into hot vinegar, and after remaining a few minutes 
should be gently squeezed so as to force out nearly all the liquid. 
Apply it immediately, and confine by compress and bandage. 
Should it fail to act properly in three or four hours, remove it 
and repeat the hot vinegar. 

The only objection to this form is that careless operators, fail- 
ing to squeeze the pad sufficiently, have inflicted a much more 
extensive blister sometimes than was desirable. Laid on the 
epigastrium, the dripping vinegar, holding flies in solution, has 
begirt the body, and formed a complete blistering band. A little 
care will avoid such a catastrophe. I may add that the pad- 
blister, of various sizes, can be more conveniently carried about 
by country physicians than the ordinary ointment or plaster. 

Various formulae are given for the preparation of the em- 
flastrum cantharidis or fly-plaster. The following is about as 
good as any other: — -Melt together a pound of good flies well 
pulverized; a pound and a half of wax plaster; half a pound of 
fresh lard, frequently stirring, so as to make a uniform mixture. 
For warm weather, suet should be used in place of lard, to give 



272 FLY OINTMENT. 

firmer consistence. The mass can be kept in a jar, or made into 
rolls, as may be most convenient. 

A late writer recommends the following as having some ad- 
vantages over other prescriptions. Take of bruised flies, four 
ounces ; infuse them in six ounces of boiling water ; strain, and 
evaporate by a slow fire to the consistence of syrup ; then add 
four ounces of beeswax, one ounce of yellow rosin; of sweet oil 
and spirits of turpentine, each an ounce; alcohol, two ounces. 
Mix the ingredients intimately by a sufficient amount of heat to 
melt all the solids. 

Under the belief that chloroform added to cantharides would 
improve the quality of blistering plaster, Dr. Landerer, of Athens, 
recommends that this plaster be made by digesting the pulv. can- 
tharides for several days at a gentle heat in a sufficiency of 
chloroform to moisten it. The mass is then to be added to the 
usual blistering plaster, half cold, taking care to avoid the in- 
halation of the chloroform. Of course it must be kept in tight 
vessels and be applied speedily or the chloroform will all pass 
off. — O-azette des ITospitaux, No. 69. 

A merely warming or rubefacient plaster may be formed by 
adding half a drachm of powdered flies to an ounce of melted 
adhesive plaster, stirring until cold. To use any of these plas- 
ters, a portion should be melted in an iron ladle, and properly 
spread on soft linen or leather. 

The fly ointment (unguentum cantharidis) is a very popular 
article for vesicating, and many formulae are given for its proper 
formation. In practice, I have rejected all the printed rules, 
and prefer to make my fly ointment by rubbing into basilicon 
ointment as much of the fine powder of flies as can be incorpo- 
rated with it. The ointment is thus saturated with flies, and will 
raise a blister with great certainty. It is far preferable to the 
practice of spreading basilicon ointment on leather and covering 
the surface with flies. The surface blistered by this kind of 
plaster is apt to be more or less coated with particles of the flies, 
which keep up irritation long after the vesicant effect has been 
produced. 

Formerly errors were constantly perpetrated by allowing a 
blister plaster to remain on the surface too long, and hence 
strangury was a very frequent attendant or result. In place of 
from twelve to eighteen hours, four or five hours are now found 
to suffice. And instead of waiting to have full vesication, the 
plaster should be removed at the end of four or five hours and 
a soft bread and milk poultice applied. This gives speedy relief, 
and insures the prompt separation of the cuticle and the copious 
effusion of serum. If it is desired to act on the scalp, the plas- 
ter should remain from twelve to eighteen hours, and even then 



STRANGURY — THE BLISTERING POINT. 273 

there will be only an oozing of serum, and not a separation of 
cuticle, as in ordinary cases. 

The strangury sometimes induced by blisters is often a very 
alarming accident, and, although not at all dangerous, is a source 
of great disquiet. It may be obviated by the early application 
of a soft poultice, and the free use of diluent drinks, such as 
gum Arabic water, barley water and saltpetre, slippery elm in- 
fusion, &c. ; the drinks should be administered from the moment 
of applying the plaster until the vesicant effect occurs. If 
strangury has actually taken place, it may be relieved by apply- 
ing cloths to the pubes, soaked in hot water, by the warm bath, 
by injecting warm water per anum, adding from sixty to eighty 
drops of laudanum to the water. 

Why do the same flies and the same ointment or plaster fail 
to vesicate one person, while another in the same house and at 
the same time is effectually blistered by materials taken from 
the same bottle or jar? Every practitioner has been compelled 
to ask himself this question over and again. That the material 
is not at fault he is positively certain, because its perfect opera- 
tion, as well as its entire failure, stares him in the face. What 
is the matter? 

I once heard a distinguished physician, who was subsequently 
a professor of some renown, curse a village apothecary for keep- 
ing a worthless fly ointment, which I was employing at the very 
same time with the happiest effect. The ointment, in both cases, 
had been made more than a month, and was taken from the same 
pot. Is there no proper explanation? I reply, unhesitatingly, 
Dr. Mush's blistering point is the secret. To be sure there are 
some who have ridiculed this idea as purely chimerical, but they 
offer no adequate substitute, nor can they. Stokes and Graves, 
with more good sense, have recognized this blistering point, and 
all practical men can easily discern it. The phraseology is un- 
important, if we retain the idea, which is plainly this: — There is 
a condition in the human economy which is essential to the 
right action of cantharides on the surface. If the excitement 
be above or below that condition, a blister will not act at all, 
or it will do positive mischief. Who thinks of laying a blister 
plaster on the chest to relieve a man of acute pleurisy, whose 
pulse is full and bounding, prior to the use of cups, or leeches, 
or the lancet ? Fortunately, a blister would not act at all under 
such circumstances, or, if any action ensued, it would consist in 
irritation, the natural tendency of which would be to make the 
matter worse. 

Various applications are made to blistered surfaces. The 
cuticle, having been punctured with a sharp lancet to evacuate 
the serum, is often dressed with simple cerate, or fresh unsalted 



274 DRESSINGS FOR BLISTERED SURFACES. 

lard, or with wilted cabbage leaves. Finely carded cotton was 
proposed many years ago by Dr. Merrill, of Natchez, as a dress- 
ing to a blistered surface, to induce speedy healing. Maclagan, 
a foreign physician, has claimed this as his discovery, but the 
merit, if there be any, is due to Dr. Merrill. "When it is desir- 
able to keep up the irritation of the blistered spot, fly ointment 
diluted with an equal quantity of lard, or savine ointment, will 
answer the end effectually. What is called a perpetual blister is 
kept up in this way, and will often prove very effectual to relieve 
local pain. But it is sometimes preferable to renew the appli- 
cation of the blister once in two or three weeks, and to change 
the location a little on each renewal. 

It is sometimes important to apply blisters not directly over 
the seat of disease, but to a part somewhat remote. The truth 
of this position I have often tested most satisfactorily. My first 
case was that of a lady who had labored a good while under 
painful stricture of the chest, with occasional hemorrhage and a 
troublesome cough. Instead of blistering any portion of the 
chest directly, as had been my practice in similar cases, the ap- 
plication was made high up on the inside of the arm. The effect 
was far more salutary, and there was much less exposure of her 
person. The raw surface could be more easily dressed and 
otherwise disposed of than the breast could have been. I think 
that few physicians would hesitate to adopt this course after a 
single trial. 

In conformity with the above position is a statement made 
by Heister, in his Medical Observations, published in 1755, part 
first. He affirms, unhesitatingly, that he could more certainly 
and uniformly relieve inflammation of the eyes by blisters laid 
on the crown of the head than by applying them anywhere 
else. The good effect was speedily realized. Every one has 
seen the salutary operation of sinapisms, and of a hot bath to 
the feet and ankles, for the relief of headache. 

The external use of blisters to the chest after bleeding, in 
cases of acute pleurisy, is meant chiefly for the relief of pain by 
counter-irritation. The morbid excitement is transferred from 
the pleura to the skin; and, if the irritation and discharge be 
maintained by stimulant ointment, there is, in addition to coun- 
ter-irritation, some depletion from the part. And the drain may 
be so profuse occasionally as to debilitate, in which case the 
cantharides may be said to act as a sedative. We have already 
seen that a blister will not act beneficially in the case, but other- 
wise, if there be high arterial excitement in the system. 

Another happy use of external blisters is for the cure of vesical 
paralysis, which is a very tedious and troublesome affair. Mr. 
Laycock strongly insists on the benefits derivable from a blister 



BLISTERS FOR YOUNG CHILDREN. 275 

laid on the sacrum, and a repetition of the same if relief was 
not very apparent. He speaks of a man who had his urine 
drawn daily by a catheter, for three weeks, but who never re- 
quired that aid after the application of a blister. 

Repeated blistering has been successfully tried in chorea by 
Dr. Max Simon and others, as we learn from the Dublin Hosp. 
G-az. for December 1, 1855. The most affected side was chosen 
for the place of application and repetition, shifting about so as 
to get a new spot for action. All the spasmodic symptoms ceased 
in a treatment of seven or eight days. If the head be much 
affected, a blister should be applied to the nape of the neck, and 
suppuration should be encouraged by basilicon or some other 
stimulating ointment. Rarely has it been needful to blister 
more than three times. As tonics are useful in most cases of 
chorea after due intestinal evacuation, the blistering practice 
should be followed with sulph. quinine and iron. 

In obstinate diarrhoea, and in the last stage of chronic dysen- 
tery, blisters laid on the wrists and calves of the legs often give 
very great relief. The counter-irritation thus set up without 
sometimes more than balances the morbid action within, and a 
permanently salutary effect is visible. There is an advantage 
here superadded to the mere counter-irritation, which makes the 
blistering an important means. The raw surface affords a very 
good inlet to the bowels and entire system for the influence of 
the salts of morphia, whose direct action on the stomach and 
bowels might be hurtful. I have more than once witnessed the 
good effects of this blistering practice, followed by the ender- 
mic use of anodynes and sulphate of quinine, in cases badly 
managed by drastic cathartics and so converted into low forms 
of fever, designated by the injudicious prescriber as typhoid, 
typhus, &c. &c. 

The propriety of applying blisters to young children has been 
discussed at some length in the foreign journals, and in some of 
those in our own country. But I am well satisfied, from the 
actual use of them in very young subjects, in my own family 
and elsewhere, that they are just as proper and quite as bene- 
ficial in many infantile diseases as in those of adults. The real 
ground of difficulty lies, not in the cantharides nor in the tender 
age of infancy, but in want of discretion and judgment in the 
application. If the high excitement of the system has been 
properly reduced, it matters not how young the child may be. 
In bronchitis, at the age of three months, after emetics and 
leeches had been employed, I found the action of a blister to be 
exceedingly serviceable, and no untoward result ensued. A 
writer in the London Lancet for August, 1846, very strongly 
advocates the importance of blisters in infantile bronchitis. 



276 INTEKNAL USES OF CANTHAEIDES. 

Similar views are held by a writer in the American Journal of 
Medical Sciences for October, 1847. 

When Ricord, now a celebrated teacher in France, was in this 
country, he ascertained that the strong tincture of cantharides 
applied to parts bitten by venomous reptiles was promptly salu- 
tary. Irritation and vesication are set up, and the sting comes 
away with the loosened epidermis. So, also, a very strong tinc- 
ture frequently applied to obstinate ulcers induces a new and 
healthful action to ensue. 

Blisters have been employed very successfully in the treat- 
ment of erysipelas, and the practice originated with the late 
Professor Physick. I witnessed his application of them in ery- 
sipelas of the face, involving the eye, and located in other parts 
of the system. The blister was placed partly on the inflamed 
and partly on the sound spot. Piorry, of France, has adopted 
the same treatment. 

The internal uses of cantharides are also valuable. The 
forms of administration are tincture, powder, and pill, 

In suppression of the menses of feeble women the flies are 
supposed to act as an emmenagogue, though it is quite evident 
that they cure, if at all, by another agency. The following 
prescription has been employed with good effect: — 

R. — Carbonate of iron, 
Powder of calumbo, 

of ginger, each a drachm ; 

of cantharides, five grains. 

Rub well together and divide into ten powders. One to be given every three 
or four hours, in syrup or sweetened water, until strangury is set up. 

There is clearly a tonic property in this medicine, and the 
irritation induced in the neck of the bladder is propagated by 
contiguous sympathy to the uterine organs. The tonic action no 
doubt improves the quality of the blood, which is often a very 
important matter in the management of catamenial derange- 
ments. We are not of those who believe in the direct emmena- 
gogue action of many medicines. If any possess this power, the 
number is very limited. Hippocrates held that cantharides were 
truly possessed of this power, and hence he gave the article in 
amenorrhoea of various grades. 

In 1735, Dr. Burton, of England, gave cantharides in per- 
tussis, and declares that he had almost uniform success. The 
following was his prescription : — 

R. — Powder of cantharides, 

of camphor, each a scruple ; 

Peruvian bark, three drachms. 
Mix, and give eight or nine grains every three hours to a child from three to 
five years old. 



INTERNAL USES OF CANTHARIDES. 277 

He gave it in a tablespoonful of water, with a few drops of 
copaiba. The modus operandi is obscure. It is probable a di- 
uretic as well as an expectorant and tonic quality were combined 
in this treatment. Dropsy has been treated with preparations 
of cantharides in virtue of their diuretic action. It may be 
that the same agency is exerted when the medicine acts favor- 
ably on gleets and fluor alius, though it is more than likely that 
high irritation of the neck of the bladder, or strangury, has 
much to do in the premises. A case of old gleet is given in the 
Edinburgh 3Iedical Essays, cured by taking a half-ounce of the 
tincture of cantharides in a few hours. In that case intensely 
severe strangury was induced. 

Somewhere about the year 1693 a Dr. Groosvelt was im- 
prisoned, in England, for administering very minute doses of 
cantharides internally, notwithstanding the authority of Hippo- 
crates. The adult dose of the powder of flies is from half a grain 
to a grain, made into a pill, and repeated twice a day. 

Dr. Vaughan, of the Leicester Infirmary, England, published 
what he called remarkable effects of cantharides in paralytic af- 
fections, in the Memoirs of the Medical Society of London for 
1794. Several cases are referred to ; but that of a young man 
is particularly named, who became entirely paralytic, and who 
recovered under the vigorous treatment employed. Besides 
three-grain doses of the cantharides he took also forty grains 
of carbonate of ammonia every six hours. The stimulant effects 
of the medicine, and especially the severe strangury induced, 
seem to have<>had a prominent share in the curative agency. 
This exhibition of cantharides, as well as of the volatile alkali, 
was unusually energetic and rather hazardous. 

In diabetes and tetanus the flies have been employed success- 
fully, in substance and in tincture, and in both instances the 
effect is due to a considerable extent to counter-irritation. The 
first cases on record, so far as I know, of the successful exhibition 
of the medicine in tetanus, were reported by Dr. Samuel Brown, 
formerly professor of theory and practice in Transylvania Uni- 
versity. Subsequently Dr. Ffirth, of South Carolina, reported 
success with the same mode of treatment. The reports of both 
may be seen in the New York Medical Repository. The design 
of these gentlemen was to induce decided counter-irritation 
in the mucous membrane of the bowels and in the neck of the 
bladder. The dose of the tincture given in the cases reported 
was from thirty to one hundred and twenty drops, repeated every 
hour or two hours. 

The tincture is made of very variable strength. Dupuytren 
employed a saturated tincture. A very good tincture is formed 
by macerating three drachms of good powdered flies in a quart 



278 POISONOUS ACTION OP PLIES. 

of brandy for eight or ten days, and filtering. The adult dose 
is from twenty to sixty drops. More than a hundred years ago, 
Dr. Morgan used a tincture made by adding an ounce of the 
flies to a pound of elixir of vitriol, digesting for a week and 
filtering. The dose for adults was from fifteen to forty drops 
three times a day. 

The pitting or scarring of smallpox has been effectually pre- 
vented by the use of acetum cantharides. Mr. Startin tells us 
he applies it, by means of a camel's-hair pencil, to the apex of 
each spot or pustule on all the exposed surface of the body till 
blistering is evinced by the whiteness of the skin. Then the 
surface is to be washed off with water or thin arrow-root gruel. 
Between the fourth and eighth day of the eruption is the best 
time for the application. The after-treatment consists in keep- 
ing the parts clean. — Med. Times and G-az., February, 1857. 

The acetum cantharides is made by macerating for eight days 
two ounces of powdered cantharides in a pint of acetic acid. 
The strained liquor is a prompt vesicant. 

While a grain or less of the powder of flies will prove diuretic, 
without any strangury, a large portion will arrest entirely the 
discharge of urine and set up severe strangury. The usual 
symptoms of poisoning by this article are stricture of the fauces, 
vomiting or painful efforts to vomit, strangury, tenesmus, inflam- 
mation of the kidneys and bowels, &c. &c. 

The Edinburgh Medical and Surgical Journal for October, 
1844, has two cases of poisoning, one of which terminated fatally, 
the other in recovery. A man, aged thirty, took twenty grains of 
cantharides in some food, in a joke, probably for the purpose of 
exciting the genital organs. The symptoms above-named were 
developed. The man was saved by the exhibition of bark, wine, 
and laudanum. 

Another man, aged forty-five, swallowed fly-plaster in mistake 
containing about two drachms of flies. Emetics were given, 
followed by mucilaginous drinks. . In seven hours he was quite 
cold, without pulse, and died at the end of twenty-four hours. 
Dissection showed inflammation of the brain and stomach. The 
man was insane and paralytic before he committed the act. 

The London Lancet records the case of a woman poisoned by 
accidentally swallowing fly-plaster in chocolate. A piece of the 
plaster as large as a walnut fell into the vessel in which the choco- 
late was boiled, unnoticed at the time. High inflammation of the 
kidneys ensued, accompanied by gastric distress, strangury, &c. 
Leeches, fomentations, aperients, and demulcent drinks consti- 
tuted the treatment, and restored her. 

There is another case mentioned in one of the journals that 
has some special importance attached to it because it is unique. 



CAYENNE PEPPER. 279 

A girl lost her life by using the ointment of cantharides in 
mistake for sulphur ointment in the management of itch. It is 
stated that the cuticle was much abraded by the continual 
scratching. 

The G-azette des Tribunaux records the case of a man whose 
life was attempted repeatedly by the introduction of cantharides 
into his food. He was seized with severe pains in his stomach 
and bowels, together with strangury. At length the villany was 
detected, and the man recovered. 

The American Journal of Medical Sciences, vol. xvii., fur- 
nishes some facts in relation to the poison, by cantharides, of 
several negroes, to which the reader is referred. 

No sort of oil should ever be given in a case of poisoning by 
cantharides, as it increases the danger by giving greater solubility 
to the cantharidin. 

Capsicum Annuum. Cayenne Pepper. Capsiei Baccce. — 
The uses of this article as a condiment are too well known to 
need particular remark. A large quantity of the powder em- 
ployed for that purpose is prepared in this country. The 
African cayenne is decidedly more powerful as an internal and 
external stimulant, rubefacient, &c. 

Adulteration has been practiced even in regard to this article, 
by the addition of saw-dust and red lead. The latter is a dan- 
gerous combination. To detect it add water, stir a few minutes, 
and then allow the mixture to settle. The lead will fall to the 
bottom and may be separated easily. Act on it by diluted nitric 
acid, adding to the solution sulphureted hydrogen gas, which will 
make the whole quite black or of a very dark brown. 

To get the rubefacient action digest a portion of the pepper in 
hot water, hot vinegar, or spirits. The strength of the prepara- 
tion is increased by gently simmering for a few minutes on hot 
coals. It may be applied by soaking flannel in it as hot as it 
can be borne, squeezing out the surplus liquid, and applying 
close to the skin ; or it may be rubbed on the surface with smart 
friction. It is thus employed to relieve rheumatic pains, sore 
throats, pains in the bowels, &c. &c, and the benefit depends on 
active counter-irritation. For the relief of sore throats, inflamed 
fauces, &c, besides the external application, the decoction of the 
pepper is employed as a gargle freely and often. A very useful 
application of the powder is to abate the extreme coldness of the 
feet, to which some persons are liable. A teaspoonful sprinkled 
over the inside of the stocking foot once a day, just before the 
stockings are drawn over the feet and legs, will generally afford 
the desired relief. 

Dr. Trumbull, of Manchester, England, cures chilblains with 
the concentrated tincture of capsicum rubbed freely and smartly 



280 USES OF CAYENNE — CAPSULES. 

into the parts every day for a week or ten days. (See London 
Lancet, March, 1850.) 

Many females at the catamenial periods suffer from abdominal 
pains, the discharge being quite too scanty at the same time; 
and under such circumstances a tea, as they call it, is resorted 
to by the ladies with prompt benefit. A teaspoonful of cayenne 
to a quart of hot water will make an infusion of which a wine- 
glass half full may be taken every two or three hours. The 
condition referred to is most usually complained of in cold and 
damp weather, and then the remedy is particularly applicable. 
Severe colic, induced by cold and wet feet, and not dependent 
at all on intestinal accumulation, is often relieved by the same 
infusion. 

Bergius, who lived and died long before the steam-doctors were 
born or thought of, employed cayenne pepper as a remedy. He 
treated obstinate agues by giving the pepper a short time before 
the cold stage was looked for. He preferred the infusion or 
decoction, and says he prevented a return of the fits of ague by 
its exhibition. 

Some West India practitioners recommend the use of cayenne 
pepper in the advanced stage of yellow fever, in the dose of three 
grains every two hours in form of pill, and applying poultices 
of the pepper to the feet at the same time. To prevent the pills 
from burning the throat they may be covered with dough or 
wafer. 

Dyspepsia, dependent on loss of tone in the stomach and 
bowels, has been greatly relieved by cayenne pepper in doses of 
five or ten grains. I have known dyspeptics to take a teaspoon- 
ful daily, an hour before dinner, with good effect. 

The celebrated steam medicine called No. 6 is a compound 
tincture of cayenne and myrrh. Sometimes the balsam of fir is 
added, and some nutmeg. The strongest brandy or alcohol is 
necessary to make the best quality of this wonderful medicine. 
Unfortunately the steam-doctors employ this powerful stimulant 
internally, in violation of all the rules of medical propriety. I 
knew one of them to give it to a patient laboring under apoplexy, 
and at the same time employing the alcoholic vapor-bath. They 
give it in violent colic, rheumatism, &c, and sometimes with ap- 
parent benefit. In colic with great flatulence and no obstruction 
it may not be improper. But if there be intestinal accumulation 
it must be injurious. The common- dose is a teaspoonful. 

The external application is generally safe, and it may be re- 
garded as an excellent rubefacient. 

Capsules. — These are small vessels made of gelatin, of an 
oval form, having a cavity large enough to contain a small quan- 
tity of medicine the taste and smell of which it is desirable to 



USES OF CHARCOAL. 281 

conceal. After the cavity is filled a cap is fixed and luted fast 
with a solution of the gelatin, so as to form a shut sac. The size 
is sufficiently small to allow of easy swallowing by the most cap- 
tious patient, and then, too, he is gratified to be able to take a 
nauseous dose without inconvenience. The quantity of medicine 
in each capsule is small, and hence the necessity for several to 
be swallowed in quick succession if the remedy be not of. the 
energetic class. Copaiba and cod liver oil are administered in 
this way. This contrivance is not suited to those in moderate 
circumstances, because too expensive ; and, in truth, it is best to 
take a full dose at once, undisguised, if there be no special ob- 
jection. 

Carbo Ligni. Charcoal of Wood. — The antiseptic or pre- 
serving power of this article has long been known to the world, 
and will ever be valuable. Even the charring of water-casks 
presents enough of antiseptic power to preserve water for long 
voyages. Meats are kept by contact with charcoal, and fetid 
eructations and foul breath are corrected on the same principle. 

In the Pennsylvania Hospital forty years ago the consump- 
tive wards were rendered comparatively pure by the free admi- 
nistration of fine charc®al powder to each patient, in the dose of 
a teaspoonful in milk or molasses three times a day. These 
are advantages, certainly, flowing from the antiseptic power of 
charcoal, but are nothing in comparison of the real value, ^as 
judged by Hahnemann, who has devoted thirty-five pages of one 
of his works to unfold the effects of less than the millionth of a 
single grain. What do we not owe to the revelations of homoeo- 
pathy ? 

The external uses of charcoal are closely related to its anti- 
septic power. The charcoal poultice is an excellent application 
to fetid or gangrenous surfaces, where it acts in part, also, as a 
disinfectant. This poultice is readily made by stirring into the 
common bread and milk or mush poultice enough charcoal pow- 
der to blacken the mass. It should be renewed two or three 
times in twenty-four hours. The same kind of application is 
often useful in the management of scald head. An ointment is 
sometimes employed in the same disease, made by rubbing eight 
ounces of charcoal and two of the flowers of sulphur with two 
pounds of lard. The scalp should be well cleansed by poultice 
and washing with soapsuds before the ointment is applied. Five 
or six nightly dressings are frequently enough to effect a marked 
change, provided the system be properly corrected by alteratives 
or emeto-cathartics. 

Dr. Miller, of New York, and others, have employed charcoal 
successfully in obstinate constipation, in doses of two drachms, 
with as much carbonate of soda, three times a day. Dr. Jack- 

19 J 



282 IRISH MOSS. 

son, of the West Indies, treated gastric and hepatic affections 
with charcoal. From ten to twenty grains of carbonate of soda, 
with six or eight grains of powdered charcoal, or two grains of 
ipecacuanha, in rice or arrow-root water, was the treatment, re- 
peated for several days. He affirms that it rectifies disordered 
secretions very promptly. 

Dr. Belloc, surgeon of hussars, reported to the Academy of 
Medicine of Paris the successful use of charcoal in nervous gas- 
trointestinal affections, both of the idiopathic and sympathetic 
kind, in doses of one or two teaspoonfuls taken before each meal. 
Dr. B. took sixteen ounces in one day. It not only acts as a 
cathartic, but decidedly improves the condition of the stomach. 
— London Lancet, June, 1850. 

The employment of charcoal as a dentifrice is based on its 
powers as an antiseptic and disinfectant. It is well suited to 
clean the teeth and abate the offensive nature of any that are 
carious. 

Charcoal in fine powder has been administered by the mouth 
and per anum as a prophylactic in reference to measles, cholera, 
&c. &c. Dr. Wilson, colonial surgeon of New Zealand, speaks 
in high praise of the practice, which seems to have been very 
salutary in his hands. He learned the use of the article from 
Jackson, author of the old work on fevers, who says, " It was 
soothing and pleasant beyond the effect of common remedies, the 
excess of the evacuations being not only restrained, but the 
matter changed from blood to mucus, putrid and offensive to 
natural feculence." — Edinb. Med, Journal, Nov. 1856. 

Carrageen. Irish 3foss. — This article is held by many to 
be preferable to the Iceland moss — the lichen Icelandicus. Mr. 
Bass, an English chemist, says it is highly prized by the peasants 
on the western coast of Ireland as a dietetic remedy for various 
diseases, but especially for pulmonary consumption, dysentery, 
rickets, scrofula, affections of the kidneys and bladder, &c. &c. 
This moss has all the advantages of Iceland moss without its 
unpleasant taste or flavor, and the quantity of nutriment it yields 
is surprising. It is not only very nutritious, but quite bland and 
easy of digestion. To prepare it for use steep a quarter of an 
ounce in cold water for a few minutes, and then pour off the 
liquid. Place the clean moss in a quart of new milk and boil 
till the whole is of the consistence of jelly. Strain and sweeten, 
adding spice, &c. at pleasure. Some add candied ginger-root to 
make it more agreeable. Should milk disagree with the stomach 
substitute water in its place. 

This article, as well as the Iceland moss, is altogether over- 
rated. Neither is entitled to the encomiums bestowed, having 
almost no medicinal power, though being very useful as articles 



USES OF CATECHU. 283 

of diet. They are well suited to irritable conditions of the stomach 
and bowels, and are almost always safe. 

Catechu. Extract of the Acacia Catechu, formerly called Terra 
Japonica. — It is neither an earthy nor mineral substance, but 
purely of vegetable origin, and is brought chiefly from Bengal 
and Bombay. The word catechu is of oriental origin, made of 
two words, cote, a tree, and chu, juice. The juice as it issues 
from the wounded bark is much lighter colored than the solid 
catechu, and even this differs considerably in point of color. 
The pale and dark-brown varieties are spoken of, but the only 
available test is the degree of astringency, which can be deter- 
mined by the taste. 

The astringency of catechu resides in its tannin, besides which 
it contains extractive, mucilage, and various impurities that are 
accidental. Alcohol takes up all the tannin and extractive and 
leaves the mucilage. Water is capable of dissolving enough to 
make a decidedly astringent solution. 

Catechu is employed in substance, infusion, and tincture. Re- 
laxation of the uvula and fauces, so common to singers and 
public speakers, is often relieved by chewing catechu, which is 
carried in the pocket for that purpose. An occasional gargle at 
bedtime and early in the morning is also of advantage. The 
astringency and tonic property of the catechu combine to restore 
the lost tone of the parts, and hence it is useful also in aphonia 
and hoarseness, which sometimes follow low fevers. 

Diarrhoea is often successfully treated with catechu alone, or 
conjoined with prepared chalk and aromatics. The following is 
a good formula : — 

R. — Prepared chalk, 

Powder of catechu, each a drachm ; 
White sugar, 

Powder of gum Arabic, each a half-ounce ; 
Oil of cinnamon, five drops ; 
Water, five ounces. 
Mix carefully, so as to form a homogeneous compound. 

The dose is a tablespoonful every two hours, for an adult. The 
phial should be well shaken before dispensing the medicine. 

Fissure of the nipples is treated with success, frequently, by 
the tincture of catechu, applied twice a day with a fine hair 
pencil. A few applications suffice. A strong infusion would 
probably answer quite as well. The tincture for this purpose 
may be made by macerating three and a half ounces of catechu 
in two pounds of proof spirit or brandy for the space of fourteen 
days, after which filter or strain. If the tincture be required 
for internal use add to the above ingredients two and a half 
ounces of bruised cinnamon bark. We often add this aromatic 



284 CATHARTICS. 

tincture to the usual chalk mixture. The infusion is prepared 
by macerating in a clean vessel, not very tightly covered, six 
drachms of catechu in a pint of boiling " water, adding also a 
drachm of bruised cinnamon. Strain through linen or calico, and 
add (for internal use) about three ounces of syrup, either simple 
or compound. 

The dose of powdered catechu varies from ten to thirty grains, 
and in the same proportions when given in mixture. The usual 
dose of the tincture and infusion is from one drachm to a half- 
ounce. 

It is needful for practitioners to be aware of the more im- 
portant incompatibles of catechu. Thus, we should not admi- 
nister a solution of catechu containing ipecacuanha, because the 
tannin of the one combines with the emetin of the other, forming 
an insoluble and inert tannate of emetin. For the same reason 
opium should not be added to a catechu solution. Tannate of 
morphia would be produced, and that is inert also. 

We can very speedily obtain a good deal of impure yet efficient 
tannin from a watery solution of catechu. An ounce or two 
added to a quart of hot water, well stirred, and allowed to 
settle, will part with nearly all its tannin, which will collect at 
the bottom of the vessel. It should be washed and dried on a 
filter. 

Cathartics. Purgatives. — From cathairo, to purge. In the 
literal sense a cathartic is anything that will induce a purgative 
operation. In a restricted sense it refers to medicinal agents 
taken into the stomach or bowels. Cold dash and mental im- 
pressions will often excite purging, even after medicines have 
failed ; and they are, therefore, truly entitled to be classed with 
cathartics. Blood-letting and the external use of ordinary 
cathartics will also induce intestinal evacuations, as many prac- 
titioners have proved by experience. 

Cathartics act physiologically, therapeutically, and sympa- 
thetically. The mere emptying of the canal may be purely a 
physiological act. If besides this effect the head is greatly re- 
lieved, that would be a therapeutic result, or some would call it 
a sympathetic effect. 

The most common division of cathartics is into laxatives, pur- 
gatives, and drastics, to which some add hydrogogues. The 
latter term refers to the fact that very thin copious stools are 
discharged, as we observe when the neutral salts, elaterium, and 
gamboge are employed. The term phlegmagogue denotes bilious 
stools. Cholagogue and panchymagogue have also been em- 
ployed, but they are now obsolete, or nearly so. 

Cathartics tend to augment the secretion from the inner surface 
of the bowels, but in a very different degree, as we find in the use of 



RIGHT USE OF CATHARTICS. 285 

aloes and the soluble salts. They also promote the natural ex- 
pulsive power of the canal, inducing more efficiently the discharge 
of its contents. They are the most potent and useful of all the 
eliminative medicines, meriting also to be placed- among the 
simplest and most active antiphlogistics. So abundant is their 
variety, moreover, that we find no difficulty in a wise adaptation 
to cases as they occur. There is no class that could be oblite- 
rated with greater detriment to the practice of physic. 

A cathartic merely laxative gently opens the bowels, giving a 
single discharge. A moderate use of ripe fruits, a little manna 
or magnesia, will often act in this way. A change in the diet 
even, particularly the habitual use of bran bread, will give a 
mild laxative tendency. 

Purgatives occupy a higher and more efficient grade. They 
stimulate the mucous coat of the bowels longer and more actively 
than laxatives do, and the evacuations are more numerous and 
copious. Hence they form a part of the antiphlogistic plan of 
treatment, and prove ultimately sedative. 

Drastic cathartics act with still more power, inducing also 
griping pains, more or less nausea, and sometimes vomiting. 
They are administered partly with a view to their action on the 
bowels as counter-irritants. 

It is always important in prescribing a cathartic to name the 
length of time requisite for its action. If it demand eight, ten, 
or twelve hours, it should be given at bedtime, and then the pa- 
tient will not be disturbed during the night. Saline cathartics 
and castor oil are best given early in the day. The resinous 
cathartics, sulphur, and calomel, at bedtime. It is well also to 
remember that the action may be accelerated by warm drinks, 
as molasses and water, gruel, and the like. Spasmodic pain in 
the bowels may retard the cathartic operation, unless an opiate 
be added. Under such circumstances an ounce of castor oil with 
ten drops of laudanum will be more prompt and salutary than 
the oil alone. Let it be also recollected that cathartic medicine 
sufficiently active for old resident citizens will fail in new comers 
from Europe, and if the case be decidedly febrile it may be ne- 
cessary first to deplete by blood-letting. 

It is important that young practitioners should bear in mind 
that cathartics are always most wisely administered in the early 
stage of fall fevers, especially the bilious remittents. On the 
first or second day they do service, and may be indispensable. 
The common error is to allow a favorable remission to pass away 
unimproved, and then to expect to compensate for the blunder by 
repeated doses of active cathartics at a late period in the pro- 
gress of the disease. The plea then is that the right kind of 
stools had not been obtained, that the tongue is not sufficiently 



286 CAUTERY. 

cleaned off; and to gain these ends the cathartics are repeated, 
the mucous coat of the bowels irritated, perhaps ulcerated, and 
an incurably typhoid state is established. I know, from much 
experience in the treatment of the fevers referred to, that the 
best course is to purge actively on the first or second day, and 
then to profit by even a slight remission by the administration of 
sulphate of quinine. 

We might extend our remarks on cathartics to a great length, 
but prefer to supply obvious deficiencies when we treat of indi- 
vidual cathartics. 

Caustic, Common. (See Potash.) 

Caustic, Lunar. (See Argentum.) 

Cautery. Actual and Potential. — The actual cautery refers 
to the use of heated iron or something of that kind. The po- 
tential has reference to the action of common caustic and other 
chemical escharotic preparations. Of these latter we shall speak 
elsewhere. 

The actual cautery was formerly much more in use than at 
present. Its formidable aspect more than anything else led to 
its neglect. It has been revived in England, in the treatment of 
gangrene of the face, and with very happy results. That disease 
often spreads with ruinous rapidity ; and, by inducing an entirely 
new action in the tissues, such as the hot iron can effect, not 
only is the gangrene arrested, but healthy action is promoted. 
(See Edinburgh Medical and Surgical Journal for Jan. 1844, 
for facts in point.) 

This remedy has been successfully applied in a French hos- 
pital for the cure of contraction of the limbs, and especially for 
the retraction of the leg. The patient being chloroformed, (a 
new word,) the cautery was applied so as to make five or six 
marks of four or five inches in length round the affected and 
useless joint. The limb was then drawn out and confined in a 
metallic trough and the burnt parts were dressed. In six weeks 
after the operation the wounds were healed and the patient 
could walk on the straightened limb. Two cases were operated 
on in this way with success. (See Ranking 's Abstract, No. 10, 
p. 142.) 

The process called firing is also a form of the actual cautery. 
The instrument for effecting this consists of an iron wire shank 
two inches long, inserted in a wooden handle having on its ex- 
tremity, which is slightly bent, a disk or button of iron a quarter 
of an inch thick and half an inch in diameter, making the whole 
instrument only six inches in length. The disc is heated to 
whiteness over a spirit-lamp and applied very gently to the skin, 
so that a hundred applications may be made in a few minutes. 
Often the patient is unconscious of pain because he is at once 



CEDRON — CHEESE. 287 

relieved of suffering and astonished at the result. Chronic 
rheumatism and local palsy have been successfully treated by this 
expedient. (See Braithwaite s Retrospect, part xiii. p. 55.) 

Cedron, an article lately found in South America, is named 
as a new remedy for inter mittents. The dose is from seven to 
fifteen grains of the powdered root daily. We know nothing 
further touching it. — London Lancet, 1857, p. 460. 

Cheese. — The extensive employment of this article as a part 
of our food makes its entire history quite interesting. No rule 
can be laid down in respect of its salutary nature that will apply 
to all persons. The safest advice is to eat it very moderately, 
and never late at night. That it is indigestible in many instances 
is not denied ; and yet it would seem to aid digestion, as an ad- 
dition to pies and puddings, if eaten in small quantity. The dry 
cheese is, ordinarily, more wholesome than that which is very 
moist ; the old better than the new. 

For many years it has been known that cheese, owing to some 
unusual quality, exerted occasionally a poisonous influence. In 
the German journals may be found several very interesting papers 
on this subject, and they go to confirm the statements so often 
made in this country on the same point. 

It has happened that of a whole cask of cheese received from 
a given cheesemonger only one has evinced any poisonous proper- 
ties, and that had no obvious peculiarity about it in color, con- 
sistence, or taste. 

The symptoms develop themselves according to the quantity 
eaten, commencing in from ten to fifteen hours, but deferred now 
and then to a more remote period after the noxious meal. The 
first notes of distress are pain in the stomach, vomiting, purging, 
and dryness of the mouth and nose. The eyes, eyelids, and 
pupils become fixed and motionless ; the voice grows hoarse or 
fails entirely; the power of swallowing is impaired; the pulse 
gradually flags ; swoonings occur, and the skin is cold and insen- 
sible. The secretions and exertions, excepting the urine, are 
suspended; but sometimes there is a profuse diarrhoea. The 
appetite is not affected ; there is little or no fever, and the mind 
is unclouded. Fatal cases end with convulsions and laborious 
breathing as early as the third, and as late as the eighth, day. 
If the patient recover he feels badly for weeks, and sometimes 
never regains his wonted vigor. 

The symptoms mark this substance as belonging to the irri- 
tant poisons, although secondarily it would seem to merit a place 
among the narcotico-acrids. 

The morbid appearances are inflammation of the mucous mem- 
brane of the stomach and bowels, whiteness and dryness of the 



288 POISONOUS CHEESE. 

throat, flaccidity of the heart, and a strong tendency to resist 
putrefaction. 

That cheese is sometimes poisoned with red lead that is pre- 
sent in the annato employed to color it cannot be doubted. Mr. 
Wright has furnished a good paper on this subject in the Reposi- 
tory of Arts, vol. viii. p. 262. It presents undoubted proof of 
the poisonous action of some fine looking Gloucester cheese, in 
which the red oxide of lead was easily detected by a neighboring 
chemist. Samples of the annato employed as a coloring for the 
cheese were found to be strongly impregnated with lead. This 
very dangerous sophistication can be readily detected by macer- 
ating a portion of the suspected cheese in water impregnated 
with sulphureted hydrogen gas, acidulated with muriatic acid. 
A brown or blackish color is instantly struck if the minutest 
portion of lead be present. 

But the most embarrassing cases of cheese-poisoning are those 
in which the ordinary tests fail to discover any evidence of 
poisonous adulteration. These are of frequent occurrence. 
About twelve years ago a large number of persons sickened 
after eating of a fine-looking and well-tasted cheese, which was 
one of a cask, more than half of which had been sold in the 
same village. There was no fatal case, but some persons were 
made extremely sick, and suffered great gastric and intestinal 
distress. I was requested to make an examination of the cheese, 
and portions were sent to others for the same object. After a 
careful research no poison could be detected by the ordinary 
means, and we came to the conclusion that the source of the 
evil must have been derived from some vegetable matter eaten by 
the cows. 

The inquiries of Serturner and others go to make it probable 
that the poisonous property of cheese often depends on two ani- 
mal acids, analogous to, if not identical with, the caseic and 
sebacic acids, which we know to be chiefly the source of evil in 
poisonous sausages. It is certain that caseic acid obtained from 
cheese will destroy the smaller animals very promptly, and that 
the sebacic is even more rapidly fatal. 

I feel confident that not a little of the cheese that induces 
poisonous effects owes its pernicious quality to the same, or to a 
similar vegetable matter that is generally regarded as the cause 
of milk-sickness in new countries. If the milk and the cow 
that yields it may be poisoned, as they certainly are, what can 
prevent butter and cheese made from such milk from sharing in 
the evil ? 

As to the proper remedies it is plain that they must be regu- 
lated on general principles. In the cases referred to, bland 
mucilaginous drinks, hot fomentations, rubefacients, and ano- 



WORMSEED — CHLORINE. 289 

dynes were employed. If I were called to similar cases a resort 
would be had to the endermic use of a salt of morphia in prefer- 
ence to internal anodynes. Let it be understood that the sto- 
mach must be freely evacuated of the poisonous cheese, either 
spontaneously or by art, prior to such treatment. 

Chenopodium Anthelmintic™. Wormseed. — This is a 
perennial plant about three feet high, flowering from July to 
September, and growing in waste places in most parts of the 
United States. The seeds are small, and, like the plant, have a 
strong, heavy, rather disagreeable odor, which is due to a vola- 
tile oil. When quite dry the seeds are of a greenish-yellow or 
brownish color, having a bitter, warm, pungent taste. 

Soon after the discovery of this country trials were made of 
the seeds and oil as an anthelmintic, and especially for the lum- 
bricoid worms of children. Owing to the offensive taste and 
odor the remedy is not as popular as it should be. The oil 
enters several vermifuge compounds, and is the basis of their 
efficiency. The expressed juice of the plant and an electuary 
of the seeds have also been employed as remedies for worms. A 
decoction has been made by boiling the fresh leaves in new milk, 
and this is said to be a less disagreeable form than some others. 
The electuary is readily made by pulverizing the seeds and mix- 
ing them well with honey or syrup. 

It is generally agreed that the oil is the best mode of adminis- 
tration, though the smell and taste are offensive. The dose is 
from four to eight drops morning and evening for a child five or 
six years old. This dose may be given on sugar, or made into 
an emulsion with gum Arabic and sugar. 

Having never had occasion to employ the wormseed in any 
shape, I know nothing about it from personal observation or ex- 
perience. 

China Bogotensis is a name given to an article called new 
Bogota bark, because found near Bogota, although this name has 
sometimes been applied to other varieties. From it has been 
obtained a salt called the sulphate of quinodine, which has been 
employed by Dr. Foote, of Texas, in lieu of the quinine salts. 
Thirteen cases are reported, in none of which the head was 
affected, although the doses were larger than those of the quinine 
preparations. Its antiperiodic power is said to be very great. . 
— New York Journal of Medicine, 1855. 

Chlorine. Formerly Oxymuriatic Acid G~as. — The term 
chlorine, from chloros, green, refers to the peculiar color of the 
gas, which is held to be a simple or elementary substance. Chlo- 
rine gas is very pungent and suffocating, having a peculiar odor, 
and an astringent, disagreeable taste. The action of diluted 
sulphuric acid, four parts, on eight parts of common house-salt 



290 USES OF CHLORINE. 

(muriate of soda) and three of black oxide of manganese, by 
the agency of a spirit-lamp or a sand-bath will speedily evolve 
large quantities of this greenish gas. Long ago this mixture 
was resorted to for the purification of hospitals, dissecting-rooms, 
&c. Although non-respirable itself, yet the gas acts chemically 
on foul odors with such promptness that its own disagreeable 
qualities are soon abated and finally lost. It seizes the hydro- 
gen of those odors, combines with it, and thus destroys the native 
quality of the odors themselves, while the new compound it forms 
with the hydrogen is comparatively harmless. Fourcroy was the 
first to employ this agent as a disinfectant ; he did so as early 
as 1791. 

As further evidence of the power of chlorine to destroy the 
morbific qualities of effluvia, that are generally supposed to be 
the fruitful source of many epidemic fevers, it is important to 
bear in mind that all the operatives in and resident near to the 
factories of Belfast, where vast quantities of this gas were 
employed in the process of bleaching, were exempt from the 
fevers that desolated Ireland from the year 1816 to 1820. Not 
one of the numerous workmen experienced an attack. In view 
of such facts it is idle to dispute about the real cause of those 
fevers, whether it be malaria, or marsh miasmata, or anything 
else. 

Chlorine gas diluted with common air, and also chlorine water, 
have been a good deal employed in medical practice. 

The expectorant property of diluted chlorine gas was very 
satisfactorily shown by Ganal in his account of its effects in fac- 
tories where it was employed constantly as a bleaching agent. 
Workmen who entered the factories with cough and other at- 
tendants of pulmonary disease were soon relieved and often 
cured. The London Medical Review for October, 1833, notices 
its successful action in chronic bronchitis. For this end the in- 
halation is made from vessels containing the aqueous solution of 
chlorine. Two drachms of the concentrated solution (made by 
passing the gas into water until it will absorb no more) are 
added to a pint of water in a Woulfe's bottle, to which a flexi- 
ble tube is attached. The bottle is dipped in hot water to libe- 
rate the gas which is inhaled by the tube. The quantity of chlo- 
rine water may be increased gradually to half an ounce. Dr. 
Travart, of Marseilles, first employed this method in 1804, as 
may be seen by reference to the Medico-Ohirurgical Review for 
April, 1834. 

I had an opportunity of testing the expectorant property of 
chlorine in my own person in the year 1837, while engaged in 
my course of lectures on chemistry in Transylvania University. 
I had labored under a cold for several days, and expectorated 



ACTION OF CHLORINE. 291 

with difficulty, but was very unexpectedly and speedily relieved 
by the accidental fracture of the retort in which I was preparing 
chlorine gas for exhibition. A sudden escape of the gas, not 
very much diluted, by the way, almost suffocated me; but no 
sooner did I get access to the open air than I began to feel 
better. The act of coughing was more easy, expectoration soon 
quite free, and before the next day the unpleasant companion 
had left me. 

Dr. John Redman Coxe, formerly professor of chemistry in 
the University of Pennsylvania, has published an account of 
morbid effects on his person from the accidental inhalation of 
chlorine gas. Inflammatory action was induced, which called 
for blood-letting and other antiphlogistic remedies. In his case 
the gas came in contact with structure not diseased, as was mine, 
and hence the difference in the result. In my person the irri- 
tant poisonous gas really operated as a counter-irritant, or con- 
tra-stimulant, and so proved salutary. In a thousand instances 
we may discover opposite results to flow from the action of the 
same cause in different persons, and even in the same person at 
different times. 

Mr. Mann, of Clerkenwell, exhibited chlorine water with very 
great success in the late Asiatic cholera in England. He em- 
ployed the concentrated watery solution with a little sulphate 
of soda. From one to two drachms diluted with water were 
given every hour until the symptoms abated. It invariably 
arrested the pains, purging, and vomiting. Of nearly one 
hundred cases treated in four days only two died. We suppose 
the diluted liquid chloride of soda would answer equally well. 
(See Braiihwaite s Retrospect, part xx. p. 345.) 

In loiv fevers, where the powers of life are greatly exhausted 
and a tendency to a putrescent state apparent, much benefit has 
been derived from the internal use of chlorine water. It acts as 
a stimulant, and seems to counteract, more than any other agent, 
the typhoid element of those fevers on which their fatality proba- 
bly depends. Two drachms of the strong aqueous solution may 
be mixed with three ounces of distilled water, and a tablespoon- 
ful given at a dose, so as to consume the whole in one day. The 
proportion of chlorine water may be increased gradually till it 
reaches five or six drachms. The mixture elevates the pulse, 
excites gentle perspiration, and neutralizes the offensive odor of 
the intestinal discharges. A similar practice has been useful in 
malignant scarlet fever, and will be noticed in another place. 

An Italian has reported success in the treatment of hydro- 
fliobia by means of a mixture of four scruples of the chlorine 
water with four ounces of aromatic water and a half-ounce of 
syrup of lemons. But the statement needs confirmation. 



292 ORIGIN AND NATURE OF CHLOROFORM. 

Some French surgeons have employed the chlorine gas and 
water by way of injection, in lieu of wine, for the radical cure 
of hydrocele, with success ; and the fact, most probably, led Vel- 
peau to try iodine for the same end. 

Chloroform. — The notoriety acquired by this article as an 
anaesthetic agent entitles it to a short notice here. The books 
tell us, for the most part, that it was simultaneously discovered 
in 1832, by Souberain and Liebig; but I judge this to be an 
error. Mr. Guthrie, of Sackett's Harbor, New York, prepared 
what I suppose to have been the same article, substantially, in 
1830; and in my Elements of Chemical Philosophy, published 
in 1832, mention is made of the fact. I infer this from the 
method of forming the article, as found in the books, correspond- 
ing very closely with the plan pursued by Guthrie. In the last 
edition of Christison's Dispensatory, it is said that "chloroform 
is now prepared by the action of bleaching powder (chloride of 
lime) on either alcohol or pyroxylic spirit." The ingredients 
used by Guthrie in 1830 were chloride of lime and alcohol. He 
designated the product chloric ether, which differed from the 
present chloroform, if at all, in the fact of a large dilution with 
alcohol. The properties ordinarily assigned to chloroform, apart 
from its anaesthetic quality, were the same with those resulting 
from the use of the chloric ether of Guthrie* The latter was 
held to be a diffusible stimulus, a good antispasmodic, and acting, 
in short, very much like sulphuric ether. Having had in my 
laboratory a quantity of the chloric ether of Guthrie, and fre- 
quently exhibiting it, my impression is quite clear that it is in 
no sense a different article from the modern chloroform, except- 
ing in respect of the dilution already hinted at. 

Some have described the chloroform as transparent and color- 
less, and such was the appearance of the chloric ether ; but it is 
sometimes asserted that chloroform has a yellowish tinge, which 
is the fact. It is considerably heavier than water, having a 
peculiar, fragrant, ethereal, apple-like odor, with a slightly acid 
and intensely sweet taste, in all which respects, excepting 
density, it agrees with the qualities of the chloric ether re- 
ferred to. 

The properties assigned to chloroform are various. In very 
large doses it is, like all ethereals, a narcotic poison, and some- 
times evinces narcotico-acrid effects. In smaller doses it is 
stimulant or sedative, according to the state of the system, anti- 
spasmodic, anodyne, and ancesthetic. 

The mode of exhibition is either by inhalation or by mixture 
internally administered. Various contrivances have been re- 
sorted to, especially by dentists, for the easy and comfortable 
inhalation of the article. It will be found, however, on trial, 



EFFECTS OF CHLOROFORM. 293 

that as good a mode as any is to make use of a silk handker- 
chief, on which some twenty, thirty, forty drops, or more, are 
placed. In lieu of this, a clean soft sponge will answer very 
well. The latter, or the handkerchief charged with the chloro- 
form, is applied to the nose, that the party may inhale the vola- 
tile matter. 

The usual effects in what is regarded a fit subject are soon 
apparent. Whizzing and pulsation in the head, an imaginary 
change in the color of objects, sensations and feelings of an 
agreeable sort, more or less loss of consciousness, a soft slumber, 
or propensity to laugh, or to talk incoherently, or to be boister- 
ous. This state of things ordinarily continues some five or six 
minutes, and after it has subsided there is frequently no recollec- 
tion of what has happened, and often no remembrance of pain, 
though several teeth may have been extracted. 

If a much larger quantity be inhaled, as a drachm or two, the 
cerebral effects will be more obvious, and fatal results may occur. 
A reference to the article ether will show that the inhalation of 
the gas of sulphuric ether has acted much in the same way. 
Several volumes have been given to the public setting forth the 
safety and happy consequences of this practice. But one of the 
most recent writers on parturition (Dr. W. Tyler Smith) declares 
that the enthusiasm of novelty having subsided, the chloroform 
treatment is falling into disuse. I have not space to enter into 
details, and can only add my own conviction that it ought to be 
discarded, and that in less than ten years it will be — I mean, as 
an obstetric medicine. 

But chloroform has been employed for the relief- of asthma, 
puerperal convulsions, neuralgic pain, in chorea, hydrophobia, 
tetanus, delirium tremens, Asiatic cholera, epilepsy, &c. &c. 
Some very interesting cases are reported in Braithwaites Retro- 
spect, Ranking'' 's Abstract, and the London Lancet, of the suc- 
cessful management of hydrophobia, tetanus, delirium tremens, 
and epilepsy, by this remedy; and in all diseases which ordi- 
narily resist medical treatment and prove fatal it is quite 
proper to give a trial to the chloroform. A case of cholera is 
reported by a physician as cured promptly by this medicine. It 
was in his own person, and he had no other article at hand, and 
inhaled it until he became unconscious and fell asleep ; he awoke 
in a decidedly safe condition. 

We know of scarcely a disease more distressing to parents 
than infantile epileptic convulsions, and therefore we present 
the following testimony in favor of the internal use of chloroform 
for their relief and cure. We are well aware that the cause 
of the disease must be carefully sought for in every instance, or 
our best remedies may avail nothing. 



294 USES OF CHLOROFORM. 

The child named by Henry Bowe, Esq., in the Medical Times 
and Gf-azette for Sept. 1853, was five months old when the first 
seizure occurred. When fifteen months old the chloroform treat- 
ment was tried, as the fits had increased to eighteen per day and 
the countenance had become idiotic. Five drops were given in 
mucilage after every fit. The child slept the whole night after 
taking the first dose. The medicine was continued three times 
daily, beef tea and arrow-root being the chief diet. From April 
27, when first treated, to May 6, the improvement was rapid, and 
then he appeared not so well, because of difficult dentition. The 
dose was augmented to seven drops, and a mild cathartic was 
given twice a week. The attendance ceased on May 26, when 
perfect recovery had taken place. He was seen on July 18, and 
was in good health, the fits not having recurred. 

We commend this case to the consideration of our brethren, 
who well know how often they are baffled in the treatment of 
epilepsy. 

Mr. Childs, an English surgeon, employed chloroform with 
obvious advantage for the relief of great intolerance of light, 
attending chronic inflammation of the eyelids. One drop was 
let fall into each eye, daily, for several days, and with the effect 
of enabling the patient to look steadily at the light for some 
moments. The remedy seems here to exert a happy sedative 
influence. (See London Lancet, April, 1850.) 

Lead colic has been happily controlled by Dr. Aran by the 
external use of chloroform. From one to two drachms were 
poured on a wet cloth, and this applied for the space of half an 
hour to the abdomen with pressure. On this local appliance the 
chief dependence was placed, although the remedy was given 
sometimes by the mouth preceded by a simple enema. — London 
Journal of Medicine, January, 1851. 

Chloroform frictions over the whole body have arrested tetanus 
after the failure of other more common means. The frictions 
were repeated every half hour. — London Lancet, Aug. 9, 1851. 

That frightful form of disease called puerperal convulsions 
has been happily relieved by the use of chloroform administered 
on linen in half-drachm doses, keeping up the full effect for 
three hours. After copious bleeding and doses of morphia had 
entirely failed, this appliance succeeded. For particulars, see 
Braitliwaite, p. xxix. p. 285. 

As internal medicines are not always applicable in cases of 
chorea, it is well to know that frictions with chloroform have been 
successful, especially where the disease was induced by fright. 
Equal parts of chloroform and oil of sweet almonds well mixed 
were rubbed night and morning along the spinal column. In 



USES OF CHLOROFORM. 295 

six days the disease was conquered. (See L' Union Medicate, 
Oct. 1850. 

Dr. Laudenen, a physician at Athens, affirms that chloroform 
is a specific for seasickness. Ten to twelve drops suffice, in 
most cases, to stop the nausea, and enable those who take it to 
assume the erect posture and to become habituated to the motion 
of the vessel. If the sickness return, the dose must be repeated. 
The remedy was tried on twenty passengers during a very rough 
sea-voyage from Zea to Athens, and all with the exception of 
two were cured with one dose. The others recovered on taking 
a second dose. — Medical Times and Gazette, 1857. 

M. Latour, in £' Union Medicate for January, 1857, refers to 
a case of very obstinate hiccough which was immediately arrested 
by the employment of chloroform. 

I should feel disposed to try the chloroform in cases of pure 
neuralgic pain and irritability of the eye wholly disconnected 
with inflammation. It might be rubbed on the lids at first, and 
finally dropped on the ball of the eye. 

Several writers on Asiatic cholera, in the London Lancet for 
April, 1850, speak favorably of the use of chloroform in effer- 
vescing mixtures, and also in ten-drop doses, every quarter of 
an hour, given alone. The effect was speedily to arrest the 
vomiting and allay gastric irritability. 

M. Ricord and Dr. Escallier have lately reported to L 1 Union 
Medicate on the means of arresting the fatal effects of chloro- 
form. It is by forcing inspiration and expiration, either by 
blowing into the patient's mouth, or by thrusting two fingers 
deep into the throat, even to the entrance of the larynx and 
oesophagus. Sudden expiration ensued and recovery followed. 
(See London Lancet, Feb. 1850. 

M. Guersant, chief surgeon of the Hospital for Infants, at 
Paris, thinks that chloroform is much more frequently called for 
in the cases of infants than in those of adults, and that it is less 
apt to do harm. (See London Lancet, Jan. 1850.) 

When given internally, the dose is from five to ten drops in 
brandy and water. This is for an adult. 

That an agent like this should often excite the heart's action 
violently, and always accelerate its pulsations more or less, as 
well as develop the usual phenomena of stimulation, will not 
excite the wonder of any who recollect what the appropriate 
effects of stimuli are. And when it is borne in mind that some 
persons are much more easily excited than others, and realize 
more uniform cerebral excitement from very slight causes, it will 
not be matter of surprise that the indiscriminate and injudicious 
administration of chloroform in dental practice was followed by 



296 CHOLAGOGUES — CIMICIFUGA RACEMOSA. 

not a few fatal results, and that for a like reason its obstetrical 
application has also been occasionally disastrous. 

Chloroform has been resorted to by many distinguished sur- 
geons to induce unconsciousness and insensibility, during which 
state the knife has been employed successfully. It is proper to 
say that the professional mind is by no means agreed in regard 
to this practice ; some of the ablest surgeons holding it to be bad 
practice. Dr. Simpson, a distinguished obstetrician, and some 
American practitioners, still advocate the anaesthetic use of chlo- 
roform in natural as well as preternatural labors. 

It cannot be denied that the inhalations of chloroform and 
sulphuric ether have been practiced on a very wide scale in this 
country, and with comparatively few bad results. Some prefer 
the ether, while others give a decided preference to chloroform. 
We need not say that the use of either calls for wise discretion. 

A very grave question of medical jurisprudence was raised in 
this city not long since, involving the character of a dental prac- 
titioner not a little, growing out of the administration of one of 
these anaesthetics to a female. We are not disposed here to dis- 
cuss the merits of that case, and will be sufficiently understood 
when we declare, as we do most conscientiously, that in our judg- 
ment the final act of Governor Pollock in the Beale case was just 
and proper. His reasons for the act accord with our views of 
the case while the trial was progressing. 

A writer in the Medical Times and Cf-azette for Dec. 1856, 
(anonymous,) says he has used chloroform in at least one thou- 
sand cases, and never with bad consequences. He takes the pre- 
caution of giving the patient a glass of spirits or wine before 
the chloroform is administered. He prefers the spirits even for 
ladies, and thinks that the stimulus of the spirits keeps up the 
heart's action so as to prevent sinking altogether. The expe- 
dient is worth repetition. 

Cholagogues. These are medicines which are supposed to 
stimulate the liver to greater activity and to promote the excre- 
tion of bile. Mercury is usually placed first on the list of chola- 
gogues. The sulphate of manganese is said by Grmelin and others 
to possess the same quality. Rhubarb, aloes, and taraxacum, 
appear to act very happily on the liver. Indeed all cathartics 
may be said to operate, as indirect cholagogues, more or less 
efficiently. 

Chondrus Crispus. (See Carrageen.) 

Cimicifuga Racemosa. Actcea Racemosa. Black-Snake 
root. Black Cohosh. Squawroot. Rattle Weed. Macrotys. 
— This plant is a native of the United States, and is abundant 
in various parts of the country. The Indians knew it well, and 
relied much on its medicinal powers. The root is black ex- 



USES OF CIMICIFUGA RACEMOSA. 297 

ternally and white within, having a large head with numerous 
long fibres. The taste is bitter, with some astringency, and the 
odor not very remarkable. Boiling water extracts all the virtues, 
and hence an infusion or decoction will contain its active proper- 
ties. 

The term squawroot had its rise in the employment of the de- 
coction to facilitate childbirth, and hence it has been called an 
emmenagogue. A very common use by the Indians was for the 
cure of persons bitten by snakes, and hence another name, viz., 
snakeroot. The Thomsonian or steam-doctors profess to make 
large use of the cimicifuga, and they call it astringent, diuretic, 
sudorific, anodyne, and expectorant. 

We notice it here especially for its alleged powers in the treat- 
ment of chorea. The late Professor Physick employed it in the 
management of this disease nearly half a century ago. In the 
ninth volume of the American Journal of Medical Sciences, 
Dr. Young called attention to its remedial efficacy. In the same 
journal, vol. xxv., is a paper by Dr. Kirkbride confirming the 
views of Dr. Young. Both gave the medicine in powder, in the 
dose of half a teaspoonful for a girl ten years old, three times a 
day. Dr. K. employed a decoction also, made by boiling an 
ounce of the root in a pint of water twenty minutes. The dose 
was a wineglassful three times a day to a girl ten years old, 
gradually augmenting it. The late Dr. Otto and Professor 
Wood report favorably of the remedy in the same disease. The 
largest doses given by Dr. Kirkbride failed to excite the pulse, 
induced no pain nor heat in the head, and very little nausea, but 
generally proved moderately laxative. 

Dr. Mears, in a paper published in one of our journals, re- 
gards it as a good medicine for obstinate intermittens and 
chronic diarrhoea. 

The powers of this medicine have been highly extolled by 
Professor Green, of the New York Medical College, in a monthly 
journal of this year. He employs a saturated tincture, made of 
four ounces of the root to one pint of alcohol. Of this alone 
from twenty to forty drops may be given every two hours, in 
acute rheumatism. 

In chronic bronchial disease and in the early stage of phthisis 
it has proved to be very efficient, combined with an anodyne and 
the saturated tincture of blood-root, which may be made as in- 
dicated above for the black-snake root tincture : — 

R. — Tinct. acteae racemos. 

Tinct. sang, canad. aa ^i ; 
Sulph. morph. grs. ij ; 
Syr. gum acac. ^ij. 
TT[- — Dose, teaspoonful when cough is troublesome. 

20 



298 CINCHONA. 

The same writer is partial to the black-snake root also in 
chorea and dropsy. 

Cinchona. Peruvian Bark. — The cinchona or quinia woods 
of Loxa are thus spoken of in the London edition of Baron 
Humboldt's Views of Nature, (1850,) p. 390:— 

The little town of Loxa has given its name to the most effica- 
cious of all fever barks, the quinia or cascarilla fina de Loxa. 
This bark is the precious produce of the tree which is botanically 
described as the cinchona condaminea, but which (from the erro- 
neous idea that all the cinchona of commerce came from one 
tree) was called the cinchona officinalis. Sebastian Baders 
affirms that the fever bark was brought to Alcala de Henares 
in 1632 ; but others say it was brought to Madrid first in 1640, 
when the Countess de Cinchon, wife of the Peruvian Viceroy, 
arrived from Lima, where she had been cured of an intermittent. 
The finest kind of cinchona is obtained at the distance of from 
eight to twelve miles southward of Loxa, among the mountains 
of Uritusinga, Villonaco, and Rumisitana. The trees which 
yield this bark grow on mica, slate, and gneiss, at the elevations 
of 5755 and 7673 feet above the level of the sea. The cinchona 
woods are bounded by the little rivulets Zamara and Cachyacu. 

The tree is felled in its first flowering season, or about the 
fourth or seventh year of its growth, according as it may have 
been reared from a strong shoot or from seed. To procure 
11,000 pounds of the bark requires the destruction of 900 trees 
annually. The older and thicker stems are becoming more and 
more scarce ; but such is the luxuriance of the growth that the 
younger trees which now supply the demand, though only about 
six inches in diameter, often attain the height of sixty feet. The 
trees are very beautiful, adorned with leaves full five inches long 
and two broad, and stand very close together. The upper 
branches spread out, and when agitated by the wind the leaves 
have a peculiar reddish color and glistening appearance, visible 
at a great distance. The mean temperature of the cinchona 
woods varies from 60° to 66° Fahrenheit, but the extremes of 
heat and cold experienced at some parts of the temperate zone 
are never felt in the vicinity of Loxa. 

The name "Countess's powder" originated in the fact that the 
bark was dealt out by the Countess de Cinchon. But this name 
was afterward metamorphosed to " Cardinals" or " Jesuits" 
powder, because Cardinal de Lugo, Procurator- General of the 
order of Jesuits, gave to the medicine a wide notoriety by his 
praise of its virtues. 

Some of the books contain a great deal touching the true and 
false species of the bark ; but that question is now of less mo- 
ment to the physician than it was prior to the discovery of the 



CINCHONA. 299 

proximate principle whence we get the sulphate of quinine. The 
bark, as such, is seldom employed in practical medicine; and 
the manufacturers understand their interest well enough to select 
the best bark for the preparation of the salts of quinine. Expe- 
rience has taught that a great difference obtains in the various 
barks as to their yield of the quinine salts, although all the varie- 
ties are tonic. Forty years ago the red bark was much more 
costly than any other species, and was believed to be the most 
valuable as a medicine. Now it is much less prized, because it 
contains very little of the proximate principle that renders the 
yellow bark so desirable. The cinchona lancifolia gives the 
pale or quilled bark; the cinchona cordifolia yields the yellow 
bark ; while the red is furnished by the cinchona oblongifolia. 

The pale bark yields the proximate principle called cinchonine, 
and is almost destitute of quinine ; the yellow bark furnishes 
quinine largely, and almost no cinchonine. 

All the varieties of Peruvian bark have been employed for 
centuries in the treatment of intermittents, and also for their 
in the samrties, and no one doubts that they could be employed 
tonic propee way and with success still. But the bulk of the 
medicine very frequently offended delicate stomachs, and the 
article was laid aside of necessity ; and when the great substi- 
tute was discovered, its comparatively small dose was so import- 
ant a commendation that it soon supplanted the bark in all 
countries where it was tried. * 

The bark was given in powder, decoction or infusion, in ex- 
tract, and in the form of tincture. When the powder could be 
taken for a sufficient length of time it was almost always effica- 
cious. It was given usually in milk or molasses, or wine and 
water. The common adult dose was one or two drachms three 
times or oftener per day. The decoction was made by boiling 
two or three drachms of bruised bark in a pint of water for the 
space of ten minutes, adding a little cinnamon to make it more 
agreeable to the stomach. The infusion had the same degree 
of strength, but was not boiled, of course. The extract, when 
well prepared, was a better medicine than either of the above in 

* Touching the use of Peruvian bark in fever, Dr. Sims (an old writer) thus 
expressed himself: — "I. solemnly declare that I never saw a case of nervous, 
low, putrid, or malignant fever, when the patient could be brought to take this 
medicine in sufficient quantities, turn out unfavorably." He did not rely on 
less than six or seven ounces given in two days, and although some held a dif- 
ferent opinion, many of the best practitioners of the olden time acted under the 
same creed. Is not this something like a basis for the free use of sulphate of 
quinine in the same forms of fever ? 

Headland thinks that all the preparations of cinchona bear the same relation 
to arsenic in the treatment of ague that alkalies bear to colchicum in gout. 
The former in each case supplies a needful material, while the latter neutralizes 
some morbid process. 



300 huxham's tincture — BARK beer. 

very many cases. Two kinds have been in use, viz., the watery 
extract and the alcoholic or resinous extract. The latter is less 
apt to spoil, especially in hot weather ; but both are good medi- 
cines when fresh and sound. These extracts can be made into 
pills in warm weather with almost no trouble, and in very cold 
weather they are reducible to powder in a mortar. A very 
good method for exhibition to children is in the form of syrup. 
Thus :— 

R. — Extract of bark, gij ; 
Syrup of ginger, |ij. 
Reduce the extract to powder and dissolve it in the syrup. The dose may he 
from one to three teaspoonfuls three times a day or more frequently, according 
to circumstances. 

Many alcoholic and vinous preparations have been before the 
public. The best by far of all is the well-known Huxhams tinc- 
ture, called after the celebrated Dr. Huxham, who wrote so ably 
on fevers, and who employed this tincture with so much success. 
Before the sulphate of quinine was introduced I resorted to this 
tincture very frequently, regarding it as more generally suited 
to the management of periodical fevers in delicate persons than 
any other preparation. It can be made with little difficulty, 
according to the following formula : — 

R. — Powder of the pale bark, gij ; 
Bruised orange peel, ^iss ; 
Virginia snakeroot, Jss; 
Saffron and 
Red sanders, aa ^i ; 
Diluted alcohol, or 
Brandy, ,^xx. 
Mix, and digest for fourteen days and filter. 

The adult dose is from half an ounce to an ounce several times 
a day. It is not only a good antiper iodic, but a most excellent 
tonic. 

Peruvian bark has been employed in the shape of beer. A 
mixture of one ounce of bark, eight ounces of honey or sugar, 
and six pints of water subjected to a temperature of 80°, will 
soon take on fermentation, and a beer will be the product. I 
think it not at all improbable that acetate of quinine is deve- 
loped in this process, but of this I am not certain. Mutis, the 
inventor of the article, supposed that fermentation gave greater 
power to the active principle of the bark, and hence the medi- 
cinal use of his beer. Alibert tried it as a tonic in slow con- 
valescence, and in larger doses as an antiperiodic, and with 
decided benefit. The bark beer is said to be far more palatable 
than the old-fashioned dose of the powder. 

The bark poultice and bark jacket merit a passing notice. 
Although I never used a pound of Peruvian bark internally, my 



CINCHONINE AND QUININE. 301 

experience of its external application has been considerable. 
The poultice is antiseptic and stimulant; exciting new and more 
healthful action in ulcerated surfaces, and correcting the offensive 
nature of the discharges. To prepare it we make an ordinary 
poultice of bread and milk or of Indian-meal, and stir in a tea- 
spoonful or two of the powdered bark. The poultice thus pre- 
pared should be applied twice in twenty-four hours. The jacket 
or waistcoat is an old expedient in the management of cholera 
infantum. It acts not merely by its tonic power, but also by 
the mechanical support it affords. It may be made of muslin or 
flannel, and is of course shaped, as a garment should be, to suit 
the child. Two or more layers of the fabric are requisite, 
and between them the fine bark is spread out equally so as to 
make an even surface when the jacket is applied. The layers 
are then to be neatly quilted together so as to prevent the escape 
of the bark. About an ounce of bark will suffice for a jacket, 
though more can be added if desirable. Three or four of these 
jackets should be ready, so as to have them changed daily or 
every two days. Sometimes it may be useful to soak the jacket 
in brandy or in brandy and water, gently squeezing out the sur- 
plus before applying to the body. 

In addition to the above uses of the bark it has often been 
employed in the shape of injection, and is yet resorted to in that 
way by many practitioners. 

The importation of spurious bark into this country has assumed 
a frightful aspect. In about six months nearly thirty-five thou- 
sand pounds were rejected by the inspector of drugs for the port 
of New York, because almost entirely destitute of the alkaloid 
that gives value to the genuine bark. This fact adds greatly to 
the importance of the sulphate of quinine. 

Before we proceed to notice particularly the proximate prin- 
ciples of the bark, it is well to say that the old books of medicine 
furnish incontrovertible proofs of the efficacy of the bark in the 
treatment of all the forms of periodical fever then known, espe- 
cially intermittents and remittents, including yellow fever, ship 
fever, typhus fevers, &c. &c. It can hardly be matter of astonish- 
ment that the sulphate of quinine should be equally successful in 
the same forms of disease. 

Cinchonine was obtained by the pharmaceutical chemists of 
France before they succeeded in procuring quinine. Both are 
obtained very much in the same way, and have some points of 
resemblance. The cinchonine is white, crystallizable, slightly 
bitter, and not very soluble in water. The salts of cinchonine 
are more soluble, especially the sulphate, one part of which dis- 
solves in four of water at 60°. The dose is from one to four 
grains three times a day, in pill or solution, alone or with other 



302 MODES OF USING THE SULPHATE OF QUININE. 

bitter tonics.* Cinchonine and quinine are both united to kinic 
acid, in the bark, in the shape of kinates. 

To get these bases detached from the kinic acid, diluted sul- 
phuric acid is added to the powder of the bark diffused in water, 
so as to decompose the kinate, forming a sulphate of cinchonine 
or quinine, as the case may be. The sulphate is then decomposed 
by the addition of magnesia, forming sulphate of magnesia, and 
throwing down the quinine, which is subsequently purified by 
boiling with animal charcoal to make it colorless. The product 
thus obtained is nearly insoluble in water, but its salts dissolve in 
water readily. It is not difficult to make sulphate of quinine by 
adding the base to sulphuric acid until saturation is complete, the 
mixture being afterward evaporated and then crystallized. 

The salt commonly called sutyhate is really the disulphate of 
quinine, a term indicating that two equivalents of quinine are 
joined to one of acid. When twenty grains are mixed with an 
ounce or two of water, a portion settles to the bottom, and does 
not dissolve until ten or twenty drops of elixir of vitriol are added. 
Then the solution is complete, a blue tinge being imparted, and 
the disulphate being changed into a sulphate. 

The dose of the disulphate for adults is from a half to a whole 
grain two or three times a day, if intended to act as a tonic ; 
if designed as an antiperiodic, the close varies from two to 
sixty grains every one, two, or three hours. Various expedients 
have been resorted to for the purpose of abating the bitterness 
of this medicine. Sugar does not answer for this end as well as 
aromatics, such as ginger, orris-root, &c. From some consider- 
able personal experience, I would advise patients to take the 
powder in scraped apple. Placed in the centre of a small quan- 
tity and covered with the same, the dose can be taken without 
inconvenience. Thus managed, none will object to the bitter- 
ness, which has so often been regarded as a hinderance to its use. 
It has recently been announced that strong coffee, without sugar 
and cream, is the best vehicle for the administration of the sul- 
phate. 

It is affirmed by Burchardt that one grain of tartaric acid will 
neutralize three of sulphate of quinine, or perfectly dissolve it 
in water, removing all unpleasant taste effectually. — London 
Lancet. 

Eight grains of the sulphate are fully equal to an ounce of the 
best Peruvian bark, in every medicinal relation ; and it follows 
that chemistry has saved the stomach an immense amount of 

* Cinchonine is very strongly recommended by Dr. Franchini in the treat- 
ment of gastralgia. He gives half a grain three times a day, in form of pill. — 
Amer. Drugg. Gaz., July, 1857. 



ENDEMIC USE OF SULPHATE OF QUININE. 303 

labor, as its powers were undoubtedly taxed in former years to 
evolve the active principle of the bark. 

From the records in the Inspector's office in Barbadoes, it ap- 
pears that sulph. quinine was first employed there in 1824, and 
that in 1828 it was given in two-drachm doses, in the remittents 
of Berbice. — Dr. Blair on Yellow Fever, p. 147. 

The forms of pill, powder, syrup, watery and vinous solution, 
have all been resorted to, as well as the administration by injec- 
tion, by friction, and by endermic medication. To make the 
pills, a little water, with or without gum Arabic, will suffice. The 
syrup is best made with ginger or lemon syrup, adding as much 
of the salt as may be desirable. If sixty-four grains are added 
to sixteen ounces of the syrup, each ounce will contain four 
grains, and a tablespoonful will be equal to two grains. The 
watery solution is made as already indicated, and I prefer to have 
it very strongly impregnated with the salt, so that the dose may 
contain as much of the active agent as possible. 

Frictions of the sulphate, particularly in the arm-pit and on 
the spine, have been resorted to with the view of avoiding the 
bitter taste. The salt is first mixed with water or alcohol, and 
then smartly rubbed into the skin. The administration by in- 
jection also avoids the unpleasant taste of the medicine, and is 
sufficiently effective. For the same purpose, the plan of ender- 
mic medication has become very popular. To avail ourselves of 
this method a blister is laid on a given spot and the cuticle re- 
moved, after which a cerate of sulphate of quinine is applied. 
We can rub from half a drachm to a whole drachm, with an 
ounce of lard or simple cerate, and apply the whole at once. 
The application should be made once in twenty-four hours as a 
general rule. 

As some persons profess to have been disappointed in the en- 
dermic use of the sulphate of quinine I desire to insist a little 
upon it. To make it effectual it is absolutely necessary to re- 
move the cuticle entirely and to cover the raw surface with the 
quinine cerate. Not only is this method highly successful, but 
it secures the effective use of an article 'that cannot always be 
administered in any other way. The following case is in point : 
— I was called, as consulting physician, to see an old practitioner 
laboring under an intermittent, with high delirium in the febrile 
stage. He refused utterly to take the sulphate of quinine, de- 
claring that a grain would kill him. I determined to manage 
him endermically, and gave the hint to his lady, who was suffi- 
ciently intelligent to appreciate my views. The stomach was very 
irritable, and that circumstance justified the use of a blister to 
the epigastric region. I directed an eight by ten fly-plaster at 
once, advising the good lady at a proper time to tear off the 



304 HOW TO REGULATE THE DOSE. 

cuticle entirely and to lay on the raw spot forty grains of the 
sulphate well mixed with a half-ounce of cerate. The gastric 
distress was relieved, and the old gentleman complained of a 
little twinging on the skin, which he placed to the account of 
rancid cerate. The plaster was ordered to remain until the next 
day. There was no return of chill, and recovery soon took 
place. 

Not only is the unwillingness of the patient to take the medi- 
cine an argument in favor of the endermic use, hut irritability 
of the stomach is also a valid reason for adopting that plan ; 
and a more urgent plea, in the estimation of many, is the fact 
that by the endermic application we almost always avoid that 
troublesome thing called quininism. The raw surface not only 
allows the external use of the sulphate of quinine, but presents 
a favorable opportunity for the exhibition of opiates which it 
may not be desirable to give internally. 

To show the extent to which the sulphate can be safely and 
successfully applied to the raw surface, I quote a case from 
Dunglisons Medical Intelligencer for August, 1841. Dr. Cor- 
bin, of Virginia, reports as follows : — " A man had been suffer- 
ing from ague and fever for more than eighteen months, although 
treated in the usual way again and again. It was determined to 
try the endermic plan on a broad scale, and accordingly eight 
blisters were applied at once to the extremities, epigastrium, &c, 
one hour before the expected paroxysm. A cerate was prepared, 
composed of five drachms of the sulphate and four ounces of 
simple cerate, and the whole was spread on cloths of the size of 
the blisters, and in eight hours after these were applied the 
cerate cloths were laid on. These dressings were ordered to re- 
main till the parts were healed, to give them fair play. The 
result was the permanent cure of an eighteen months' intermit- 
tent. In this case the system was at once put under the influ- 
ence of three hundred grains of the sulphate, and the patient 
realized almost no quininism." 

In a neighborhood in the Middle States where intermittents 
prevail and are comparatively mild, small doses of the sulphate 
suffice — as, for instance, a grain given every hour during the in- 
termission. If the case be a simple tertian, this will answer as 
a general rule. But if it be a double quotidian, it will be ne- 
cessary to give as much as can be administered, and as rapidly 
as possible, so as to make the requisite impression on the sys- 
tem. Often it will happen that not more than two hours of in- 
termission can be had for the exhibition of the medicine. In the 
South and Southwest, where intermittents are more malignant, 
assuming what is there called the congestive form, it is absolutely 
needful to give the remedy with great boldness. The following 



LARGE DOSES OF THE SULPHATE. 305 

case, reported by my son, Dr. B. Rush Mitchell, of the U. S. 
Navy, will serve as an illustration : — 

" Mr. Swan, aged thirty-five, returned from the far South to 
Madison, Indiana, late in the summer of 1845. He was attacked 
a week after his arrival with a slight chilly sensation, succeeded, 
in a few minutes by an intense and long-continued chill, and 
followed by slight fever and no pespiration. I did not arrive 
while the patient was in the paroxysm, but learned from those 
present that throughout the w^hole of it there was scarcely a pul- 
sation at the wrist ; the whole aspect was cadaverous, and there 
was a total lack of motive power, the surface being of an icy 
coldness. The entire aspect of the patient gave the appearance 
of a dying man, and it was plainly a case of congestive inter- 
mittent. With a view of preventing a repetition of paroxysms 
I left twenty grains of sulphate of quinine, to be taken in five- 
grain doses every hour. On the next day I was called again, 
and learned that the paroxysm had recurred with greater severity, 
and I became alarmed for his safety. ,1 determined to remain 
all night, as the paroxysm recurred at ten P.M.; and fearing that 
another would be fatal, I resolved on decisive treatment. As 
twenty grains had failed to accomplish the object, I began at 
five in the evening with thirty-grain doses repeated every half 
hour. As no bad result was perceptible the doses were continued 
until nine p.m., and now, having two hundred and forty grains in 
my patient, I thought if he was not saved from another fit no 
means could avail. I stopped the medicine, and waited till ten 
o'clock. There was no recurrence of paroxysm, and I retired to 
rest. The medicine was continued in moderate doses for three 
days, and the patient completely recovered." 

Other cases could be cited from Alabama and Mississippi, in 
which more than double the quantity of the sulphate namei 
above was given in a shorter space of time, and with success ; 
nor could the patients have been saved by the small doses that 
are proper in other latitudes, where the disease assumes a mild 
form. Those who have been familiar only with the simplest kind 
of agues are not prepared to judge correctly touching the pro- 
priety of what are called mammoth doses of this inestimable 
remedy in the very malignant forms of intermittent and remit- 
tent fever that are frequently seen in the South and Southwest. 
It is, of course, impossible to fix the invariable dose of this medi- 
cine, since the quantity to be exhibited can be safely regulated 
only by the grade of malignity with which the disease is marked 
in various localities. This truth being properly estimated, there 
need be no difficulty in reconciling the extremes of one grain 
and sixty grains, as the proper doses of the sulphate of quinine 
in the management of intermittent 8. 



306 LARGE DOSES OF THE SULPHATE. 

On the subject of large doses of the sulphate of quinine, we 
quote from the British American Journal, as copied into the 
London Lancet for November, 1845. 

" In the first place, it has been shown by more than two thou- 
sand observations in this country that large doses of from ten 
to sixty grains, or an ounce of quinine, can be given without pro- 
ducing injury.* 

"2. That it has been proved beyond doubt that these large 
doses do exert a curative effect on periodical and malarial dis- 
eases, and more certainly than small doses. 

" 3. That the cases of permanent injury resulting from large 
doses of quinine are not more, indeed not so numerous, as from 
repeated small doses. 

"4. That the temporary inconvenience or disturbance of the 
nervous system is not so liable to ensue from large as small 
doses. This is stated, though our experience is to the contrary 
in most cases. 

" 5. That so far from smaller doses being more certain, they 
are not ; the paroxysm being far more likely to occur after their 
use than after a single large dose. 

" 6. That the impression made on the system is more perma- 
nent from large than small doses. 

" 7. That in diseases that run their course rapidly to a fatal 
termination, as in the southern country, a reliance on small doses 
was found to prove hazardous to the safety of the patient ; there- 
fore, when it is desirable to cut short or prevent the occurrence 
of a violent chill, the large doses should be resorted to. 

" 8. That visceral diseases are not more liable to follow, if as 
much so, from large as from small doses of quinine." 

It is notorious that persons apparently cured by this medicine 
have frequent recurrence of the same disease ; and hence some 
have fallen out with the remedy. Now we apprehend that the 
professional mind is not sufficiently clear on this point. There 
are those who will not long escape renewed attacks, if they con- 
tinue to reside in the malarious region where they acquired the 
disease at first. If they remove to a very different locality they 
find immunity in very many instances. But some may be secured 
from repetition of chill and fever and not change their residence. 
My advice was usually of this kind after I had arrested the dis- 
ease. Keep a box of one-grain pills of sulphate of quinine in 
the pocket, and take one at least every day until winter or cold 
weather has fairly set in, and avoid all unnecessary exposure. I 
have never known a person to have a second seizure who faith- 

* One of the most intelligent physicians in Mississippi gave me the details 
of a case of congestive fever cured by the use of an ounce and a half of the sul- 
phate given in eighteen hours. The patient was a young girl. 



TREATMENT PREPARATORY TO THE USE OF THE SULPHATE. 307 

fully observed this course ; but instances have occurred in which 
a failure for a single day has been followed by a chill. 

But further : I do not believe that a patient can be perma- 
nently cured of ague and fever by any quantity of the sulphate, 
or of any other medicine, in whose system there exists any con- 
siderable organic lesion or obstruction, and hence the great im- 
portance of attending to the liver, the spleen, the intestines, if 
we would make thorough work. Even typhoid fever, which is 
evidently paroxysmal or periodical to a certain extent at the on- 
set, is often cured by this medicine when there is no lesion in the 
bowels to prevent the antiperiodic action ; but that lesion being 
set up no amount of the salt of quinine can be available. The 
same is true of every form and grade of periodical fever. 

The question, therefore, so often raised by medical men, is 
greatly magnified in its relations to this whole matter. Is it 
necessary to resort to preparatory treatment before we exhibit 
the sulphate of quinine ? Does the success of this medicine 
really depend at all on such treatment ? Let us look at this 
point. We speak the language of our own experience when we 
affirm that the sulphate of quinine can do no permanent good as 
an antiperiodic while obvious obstruction or enlargement of the 
liver or spleen is present, or the intestines much inflamed or 
ulcerated. The proper means for the removal of these hinder- 
ances must be resorted to effectually before we can hope to put 
a stop to the periodical disease so as to secure the patient from 
frequent repetitions. The blue pill is among the most prominent 
means to bring about the desired change, aided, of course, by 
suitable diet and regimen. 

But even where there is no palpable evidence of obstruction 
or enlargement there may be so much gastric and intestinal de- 
rangement present as to interfere with the right action of the 
antiperiodic. The mucous coat of the stomach and bowels may 
be in a state that is not fitted for the proper operation of this 
remedy, and in such a case the use of emetics or emeto-cathar- 
tics, as calomel and ipecacuanha, will be very salutary. An adult 
should take ten grains of each of these articles, mixed, for one, 
two, or three days, so as to put the primse viae in a better condi- 
tion, and then it may be expected that the sulphate of quinine 
will do its work effectually. 

If the patient be very feeble, either from long-continued sick- 
ness or from vomiting or purging for several days, I would not 
hesitate to administer the antiperiodic at once in the most con- 
venient way. It will sometimes happen that an irritable stomach 
will be composed by the dose, or, if that method be objectionable, 
let the endermic plan or the use of injections be resorted to. In 
such persons, even if there be some visceral obstruction, I hold 



308 THE REMEDY SAFER THAN THE DISEASE. 

the doctrine that the sulphate of quinine is safer than the dis- 
ease. There is less danger from a supposed increase of the 
obstruction by the action of the remedy than from a certain 
aggravation by the shock of another chill. In cases of this kind 
we niay give the blue mass in proper doses while we are exhibit- 
ing the sulphate ; and I know from experience that the antici- 
pated good effects of both will often be realized. 

In all cases of malignant attacks, assuming the truly conges- 
tive form, as seen in the far South, we may and we must give the 
sulphate, no matter what kind or degree of obstruction be pre- 
sent. There, too, however, we may combine a mercurial with the 
antiperiodic. The addition of twenty grains of calomel to twenty 
grains of the sulphate will form a compound of great value in 
some of those cases ; the mercurial need not be given with every 
dose of the salts of quinine, of course, but just as often as the 
circumstances may demand. 

Something has been said of irritability of the stomach being 
allayed by the sulphate of quinine ; and it is proper here to say 
that Dr. Flint, of Buffalo, in a paper published in the American 
Journal of Medical Sciences, has shown conclusively that we 
may administer this medicine even when there is decided nausea 
and some vomiting. Repetition of the dose has had the effect of 
subduing entirely the gastric derangement, and thus the way has 
been prepared for a continuance of the remedy. It is, doubtless, 
owing to this sedative influence on a deranged stomach that the 
sulphate has been sometimes successful in putting a stop to the 
black vomit of yellow fever. 

Masked or disguised intermittens are most successfully 
managed with the sulphate of quinine. These are found in 
families where the open and fully-developed intermittents are 
seen at the same time. The patient may not have a chill, nor 
even an approximation to it, but at a regular hour, day after day, 
a terrible headache or earache or bleeding at the nose may occur, 
and, after a variable duration, wholly subside, the signs of health 
returning and continuing until the dreaded hour of the next 
day. All such cases are to be treated with the sulphate, just as 
if there had been a veritable chill and fever and sweat. During 
the epidemic prevalence of periodical fevers in the vicinity of 
Philadelphia, from 1822 till 1827, I had such cases frequently to 
manage. 

In February, 1849, while connected with the medical school 
in Lexington, Kentucky, I was seized with a very severe neu- 
ralgic attack in the region of the right kidney. The pain was 
excruciating, and I feared a serious organic disease of the organ. 
I was laid by and confined to my chamber for two or three weeks. 
A blister was laid on the part affected, and frequent doses of blue 



THE SULPHATE IN MASKED DISEASES. 309 

mass and acetate of morphia taken. It began to be very ap- 
parent that the disease was periodical and that the pain was 
relieved by pressure. This determined me to try the sulphate of 
quinine as an antiperiodic. 

Just at this time two of my medical friends called in and 
urged the need of emetics to clear out the stomach and bowels 
and to rouse the liver. I told them what my determination was, 
and declined their advice. After another dose of the blue mass 
and acetate of morphia I commenced with the sulphate of qui- 
nine, and took thirty grains in the course of the day and about 
ten grains on two or three successive days. My neuralgia never 
returned. 

In December, 1849, a patient came to the clinic of the Phila- 
delphia College of Medicine who had labored for months under 
a disease very much like my own. Various counter-irritants had 
been tried, with emetics and carthartics, to no good purpose. 
His attacks were periodical, though without regularity. Some- 
times one, two, three, or six days of intermission occurred. He 
was put on the use of the sulphate of quinine, preceded by a dose 
of calomel and ipecacuanha, and soon got well. The quinine salt 
was given in ten-grain doses three times a day, and after thus 
being exhibited for ten days the dose was reduced, but continued 
for several weeks. 

If it were needful many cases could be cited illustrative of the 
power of this medicine over neuralgic disease. The London 
Lancet for November 23, 1850, contains very satisfactory testi- 
mony from Mr. Hogg. After duly evacuating the alimentary 
canal he gave ten grains of the sulphate with ten drops of dilute 
sulphuric acid in one ounce of pure water for a dose. Rarely 
were more than two doses requisite. 

The Southern Journal of Medicine and Pharmacy has the 
following fact illustrative of the same doctrine of disguised in- 
termittent : — A young girl had headache for the space of four 
years, evidently periodical. She was cured by thirty-two grains 
of sulphate of quinine given in four-grain doses every hour. 
Previously she had been taking four grains of blue mass every 
other night for a week. The headache, which had recurred every 
other day with much severity, ceased after the use of the salt of 
quinine. 

The following cases, taken from a foreign journal, are also in- 
stances of masked intermittent, and prove the safety of sulphate 
of quinine when there was a manifest tendency to inflammation, 
if that state was not actually present. 

"John Meigs, aged sixteen, had sclerotic and conjunctival 
turgescence of both eyes, with pain and intolerance of light, of 



310 THE BARK AND SULPHATE OF QUININE PRACTICE. 

three weeks' duration. He has had repeated attacks of ague, 
and thinks the affection of his eyes is intermittent. 

" I examined this boy yesterday, when there was not the least 
appearance of disease ; however, this morning it returned at the 
usual period, and I directed him to take five grains of sulphate 
of quinine three times a day, which cured him. 

" Sarah Westall, eighteen, resides in a marshy district of Kent, 
and has had two attacks of intermittent fever. Now she labors 
under congestion of the sclerotic and conjunctival tunics, which 
she asserts comes on daily at noon and lasts for six hours, being ac- 
companied with severe lancinating pain, great intolerance of light, 
and profuse tepid lachrymation ; all of which subside together 
with the congestion, leaving an interval of nearly eighteen hours, 
in which she affirms that she suffers no inconvenience. This 
affection commenced ten days since. 

" I satisfied myself of the intermittent character of this wo- 
man's ophthalmia, and directed as follows : — 

R. — Sulph. quininge, gj ; 
Aq. puree, ^vi; 
Acidi sulph. dilut. 33. 

Of this mixture a tablespoonful to be taken six times a day." 

The remedy was successful. 

Enlarged spleen, so often found to co-exist with or to follow 
intermittents, has been declared by Piorry to be a frequent cause 
of ague and fever. If the physician meant to say that this 
disease was often reproduced by enlarged spleen the statement 
would be less exceptionable. It is affirmed that large doses of 
the sulphate do certainly reduce this enlargement, and some- 
times with almost incredible rapidity. The gentleman last 
named declared that under the action of this medicine in sixty- 
grain doses he could really see the reduction going on. But 
supposing this to be a little poetical, there is good reason to 
believe that the remedy does exert a salutary influence on the 
enlarged mass. 

In all old and obstinate cases it is important to examine the 
condition of the spleen and also of the liver, and suit the appli- 
ances to the actual state of things. 

Many years ago I had abundant opportunity to compare the 
bark and sulphate of quinine practice, not only in intermittents 
of all grades, but in every shape of remittents that prevailed 
epidemically in my neighborhood ; and while the almost uniform 
and speedy success of the latter was obvious, it was equally cer- 
tain that it was not followed by dropsy, as was the feeble treat- 
ment by decoctions of bark or even by the powder. I never had 
a case of dropsy under my care during five years of extensive 
practice while the periodical fevers were epidemic, but several 






THE BARK AND SULPHATE OF QUININE PRACTICE. 311 

came under my notice as consulting physician which were 
obviously induced by the exhibition of the bark. In the use of 
sulphate of quinine ten times as much antiperiodic power was 
daily developed as in the ordinary administration of the best 
bark. The secret was in making the right impression promptly 
in the shortest possible space of time. 

We have the testimony of Dr. Webb, in the Medico-Ohi- 
rurgieal Review for July, 1845, in favor of the efficacy of very 
large doses of sulphate of quinine for the removal of dropsy and 
general cachexia, associated with enlargement of spleen, as the 
product of periodical fevers. He gave to a child four years old 
a half-drachm daily, and in ten days the remedy proved effectual. 
In this case there was probably remaining a true periodical con- 
dition, which being met by the quinine, the associates or conse- 
quents of that state also gave way and recovery ensued. Other 
cases are mentioned in the same journal, of dropsy in connection 
with enlarged spleen yielding to full doses of the sulphate of 
quinine. 

I said, when speaking of the bark, that we had abundant 
ancient testimony in its favor as a remedy for all forms of 
periodical fever ; and most assuredly there is no lack of proof 
to the same point touching the sulphate of quinine. In every 
grade of acknowledged remitting fever its successful exhibition 
is beyond doubt, and in those aggravated forms called yellow 
fever, typhoid fevers, &c, which some regard as specific, we 
have equally convincing evidence. 

In the remittents, as they were seen for several years in 
the epidemic form in the vicinity of Philadelphia nearly thirty 
years ago, no medicine had half the efficacy that followed the 
use of the sulphate. The mode which I commonly adopted was 
to administer an emeto-cathartic, followed by the spiritus minde- 
reri, to deplete by the bowels and skin and to secure a remission. 
The first token of perspiration was the signal of abatement, when 
the sulphate was given in doses of two or three grains every half 
hour. To relieve the head, ice was applied to the scalp and 
sinapisms to the ankles, and occasionally a tablespoonful or less 
of the spiritus minder eri was given. If ten grains of the sul- 
phate could be swallowed under such circumstances it either 
arrested the disease at once or protracted the remission, which 
was regarded a decided advantage. On the next day, if need 
be, the emeto-cathartic was repeated, followed by the anti- 
periodic as before, and my patients were generally up at the 
end of a week, while others in the same house, and treated with 
feeble decoctions of bark, five-drop doses of antimonial wine and 
sweet spirits of nitre, were seldom as well at the end of five or six 
weeks, and sometimes had a dropsy as the sequel. But I noticed 



312 THE SULPHATE IN MALIGNANT FEVERS. 

this treatment when speaking of the acetate of ammonia, and 
need not dwell here. 

In the West many physicians administer the sulphate of qui- 
nine with calomel at once, and affirm that the febrile state is no 
valid objection to its use. Some have imagined that the free 
action of emetics or depletion by the lancet always secured 
such a remission as justified the free exhibition of the sulphate, 
no matter whether the skin was moist or not. Dr. Macgregor 
treated the bilious remitting fevers of India on this general 
principle. Dr. Blair did the same in Demarara. 

In congestive fever of the South, and in the worst forms of 
remittents, some physicians give sulphate of quinine largely 
combined with calomel, when inflammatory tokens are present. 
The calomel is added as an anti-inflammatory remedy. Ten 
grains of each have often been given every two, three, or four 
hours. The same combination was made long ago with bark. 

Dr. Wright, an English physician, in 1794 taught the import- 
ance of adding calomel to bark, in the fever of the West Indies, 
when inflammatory complication was obviously present.- — Medi- 
cal Facts, vol. vii. 

In the low remittents and typhoid fevers of the west coast 
of Africa and Rio de la Plata, the sulphate of quinine was cer- 
tain to make obscure remissions very complete, to clean off the 
tongue, and improve all the symptoms. (See London Lancet, 
July, 1846.) 

Mr. Hare, surgeon to the Bengal Fusileers, treated 421 cases 
of Bengal fever, which is often a very malignant form of remit- 
tent. His usual plan was to give scruple doses of sulphate of 
quinine to every patient with symptoms of fever, from the first 
moment of admission, and they had sometimes taken forty grains 
before he saw them. He remarks that although twenty grains 
will induce quininism in a healthy man, yet a bad fever case will 
often take from four to six scruples daily for three days with no 
bad symptom. 

Again he says, — "My hospital patients took from three to six 
scruples of the salt of quinine in twenty-four hours. The more 
severe the fever the oftener was the scruple dose given, until 
singing in the ears and deafness ensued. Bleeding was employed 
sometimes at the outset, and always according to the plan of 
Mackintosh." — Braithioaite, p. xxviii. p. 36. 

In the malignant remitting fever, called also yellow fever, 
the testimony is abundant to show the salutary action of this 
medicine. I know that conflicting opinions have obtained, but 
they are all reconcilable on philosophical principles. Yellow 
fever and scarlet fever assume very various and almost opposite 
aspects in different seasons and places, and they have been 



YELLOW FEVER CUT SHORT BY THE SULPHATE. 313 

treated successfully by means almost directly opposite. Dr. 
Beugnot, in a long paper in the first volume of the New Orleans 
Medical and Surgical Journal, shows beyond cavil that the 
sulphate of quinine was very efficacious in the yellow fever of 
which he treats. He says he employed the lancet to obtain a 
syncopal remission, and then resorted to the sulphate. Substan- 
tially to the same point is the testimony of Dr. Stone, in vol. ii. 
of the same journal. One of the army surgeons has reported 
decided success in the use of sulphate of quinine in the yellow 
fever of Vera Cruz in the year 1847, and others are equally 
conclusive to the same point. 

In BelVs Bulletin of Medical Science, vol. iv., I find some 
extracts from a paper of the late Professor Harrison, first pub- 
lished in the New Orleans Medical Journal, in which the use of 
the sulphate of quinine in yellow fever is set forth most favor- 
ably. Conceding that there is no special remedy for yellow fever 
nor for any other fevers, but that each case must be treated ac- 
cording to its own character, Dr. H. nevertheless speaks in high 
praise of thirty-grain doses very early after seizure. He men- 
tions particularly the case of a young man taken at one p.m. 
At six of the same day he was leeched on the epigastrium, and 
thirty grains of the sulphate was given by the mouth and forty 
grains by injection. The next day he was free from pain, his 
pulse had fallen from 120 to 84, skin cool, and every vestige of 
the disease had vanished. "The fever," says the writer, u was 
cut short as if by enchantment" The case cited is given as a 
specimen. No one doubts that the physicians of New Orleans 
are conversant enough with yellow fever. 

R. Birthwhistle, Esq., surgeon of the Yolage, furnishes an ac- 
count of the yellow fever as it prevailed on board that ship in 
1841. She left Chatham, England, in good condition, all hands 
well, and sailed for the West Indies ; she stopped at Madeira, 
Bermuda, Port Royal, Carthagena, Chagres, &c, places amply 
sufficient to give her crew the disease, which Mr. B. holds to be 
non-contagious. His remarks on the use of disulphate of qui- 
nine are very favorable. He held it to be an invaluable and 
essential adjunct. He did not give it till the febrile excitement 
was checked. He says the German and Spanish physicians 
gave it very early in the attack, as soon as they could detect a 
remission. 

This surgeon has some excellent remarks on the changing 
character of the disease that are of great practical value. The 
very same yellow fever taking on a typhoid aspect and forbid- 
ding blood-letting, which, prior to the arrival of the ship at 
Jamaica, was indispensable, even to a large extent. He calls 
on his brethren to bear these facts in mind, as well fitted to 

21 



314 SULPHATE OF QUININE IN YELLOW FEVER. 

reconcile contradictory statements respecting the value of the 
lancet as a remedy. He adds, the facts teach the necessity of 
adapting means to the peculiarities of each case, and the great 
need of sound judgment to do so. (See London Lancet, March, 
1846, p. 230.) 

Thos. R. H. Thompson, Esq., surgeon of His Majesty's ship 
Soudan, engaged on the Niger expedition in 1841-2, refers par- 
ticularly to Mr. Birthwhistle's remarks on the use of the sulphate 
of quinine in yellow fever, and confirms them by his own experi- 
ence in the African remittent, which he evidently regards as the 
same with the yellow fever of Birth whistle.* Mr. Thompson's 
experience of the preventive powers of the quinine salt are also 
important, and therefore we quote him at some length : — 

" Having noticed some valuable remarks in the Lancet on the 
subject of yellow fever by Mr. Birthwhistle, surgeon R. N., of 
the 3d January, and in which he refers to the use of quinine in 
that disease, I beg to add a few statements of its efficacy as a 
remedy in African remittent fever, and confirmatory of Mr. 
Birthwhistle's observations. While acting surgeon of H. M. S. 
Soudan, engaged on the Niger expedition in 1841—2, I had an 
opportunity of trying it in conjunction with chloride of mercury 
in a few cases of primary fever. It certainly answered fully; 
but I believe it would have proved more valuable had I not re- 
stricted the quantity to two or three-grain doses. 

" Of its effect in the secondary and tertiary attacks of African 
remittent, which are certainly attended with worse-looking and 
more violent symptoms than the primary, it may almost be con- 
sidered a specific. The first trials I made of it were at Fernan- 
do Po, in December, 1841, when left in charge of the sick. At 
that time the 'harmattan' prevailed, and although this is con- 
sidered a healthy season on other parts of the West Coast, it 
was most decidedly the reverse at that island. All the few 
Europeans (old residents, and well seasoned, as far as this can be 
accomplished by prior attack, &c.) were laid up with remittent 
fever of a low character ; and in all their cases I gave the qui- 
nine in doses of eight and ten grains daily with perfect success. 
This induced me to try it in other cases of secondary fever on 
board ship, and although in some of them the tongue was dry, 
foul, and cracked, with every indication of high febrile excite- 
ment, yet it had the effect of arresting the bad symptoms. Let 
me give you one short extract from the official journal forwarded 
to Sir William Burnett, Medical Director-general H. M. Navy, 

* These gentlemen had not a doubt that they were talking about yellow fever, 
with whose whole history they were abundantly familiar. Yet there are those 
in this country who never saw a case of that disease who presume to sit in judg- 
ment on veterans in the service, and even to deny their positive declarations. 



PREVENTIVE POWER OF THE SULPHATE. 315 

(from the case of Mr. Anderson, entered on the sick-list April 
30, 1842:) — 'May 10th. The remissions have become very 
obscure, skin burning hot, occasional low delirium, rapid, jerk- 
ing, but weak pulse ; the bowels have been kept freely open by 
Seidlitz, &c. The tongue remarkably foul and dry; and the two 
Drs. Pritchett (who also saw him at my request) began to enter- 
tain unfavorable views of his recovery. I therefore determined 
to try the effects of quinine, and accordingly ten grains were 
given on the evening of the 10th. 

"'Continued restless through the night, but slept a little 
toward morning, and was relieved by a gentle perspiration. 
On the 11th a very perceptible remission took place, and the 
quinine was again administered at noon, in an eight-grain dose. 
This was repeated for the three following days, when the fever 
gradually declined; and on the 20th he was so far recovered as 
to be discharged to partial duty, there being no other executive 
officer on board at the time. 

"'In this case, as in all the secondary attacks of remittent 
fever in which this remedy was tried, it produced a most marked 
and beneficial effect; and, strange to mention, although the 
tongue was in most of them foul and dry prior to the adminis- 
tration of the quinine, it very soon became moist and clean.' 
(From H. M. S. Soudan s Medical Journal, 1841-2.) 

" Subsequently, in 1844, while employed in the Rio de la Plata, 
I was induced to try it in some slight cases of typhoid fever, in 
which there existed considerable depression, a rapid pulse, and 
foul tongue, unaffected by purgatives ; and it had the most rapid 
and satisfactory effect: and I think it well worthy of a fair 
trial in this country in typhus ; but I should hesitate to use it in 
small doses, say two or three grains : my impression, as deduced 
from observations on its modus operandi, being that in small 
quantity it only acts as a temporary stimulant, thereby pro- 
ducing more harm than good; given in full doses, from six to 
ten grains, it would seem to have a different and specific effect. 

"In all the cases in which I tried it in the African remittent, 
it reduced the number, but increased the momentum and round- 
ness of the pulse. Connected with this subject, I would wish to 
bring under the consideration of medical officers serving on the 
West Coast of Africa — whether quinine in full doses has the 
power or not of warding off entirely the remittent fever? 

"It had long been known that persons affected with any form 
of intermittent fever on that coast enjoyed a certain immunity 
from the remittent, as pointed out by the late Mr. Boyle, in his 
work on diseases of Africa. I therefore reasoned that if quinine 
was known to overcome the intermittent, that remedy might be 
used in full doses and produce such an effect on the system as 



316 PREVENTIVE POWER OF THE SULPHATE. 

would prevent the attack of the other and worse form of fever, 
which is warded off by the presence of the intermittent. 

" On my return from the West Coast, from Ascension, in 1842, 
I determined to commence the experiment in my own person, 
taking daily one or two full doses of quinine ; and, although I 
may with truth say that I was more exposed than any other person 
to the exciting and predisposing causes of remittent fever — 
being almost continually on shore and in the woods, collecting 
specimens of natural history and in obtaining information about 
the natives of Fernando Po, Bimbia, Cameroons, &c. — I quite 
escaped both forms of fever. On being ordered to England, in 
August, 1842, I considered it necessary to reduce gradually the 
quantum of quinine, and just before arriving home had left 
it off entirely, when, strange to say, I was for the first time 
attacked with tertian ague in England, under which I suffered 
for some time; and it returned again at the same season, Sep- 
tember, in the following year." 

Some interesting facts touching the successful use of large doses 
of sulphate of quinine in yelloio fever may be found in Braiih- 
waite's Retrospect, part ii. p. 30. From twenty to sixty grains 
were given within six hours from the seizure, at one dose. The 
practice referred to was in the southern country of the United 
States.* 

Dr. Cummins, surgeon of the British ship Medway, gives the 
result of his experience in the treatment of yellow fever in the 
West Indies in 1852. He often gave sulph. quinine as a pro- 
phylactic, and says that he always prescribed it for this end to 
midshipmen and others just arrived from Europe ; the dose was 
three grains per day, taken as bitters. 

He thinks the salt cannot be given too soon. The earlier in 
the attack of fever the better. Twenty-grain doses were ad- 
ministered every two hours until four doses were taken. If 
deafness occurred he paused till it subsided a little, and then 
ten grains were given every two hours. The case of a man is 
stated who was made almost insane by a very few grains of sulph. 
quinine in New York, given for relief of fever acquired at 
Chagres, to whom Dr. Cummins gave twenty-grain doses for 
yellow fever without realizing any unpleasant symptom. 

This paper well merits a careful perusal. — Braithwaite, p. xxviii. 
p. 25. 

The testimony in favor of the efficacy of large and frequent 
doses of sulphate of quinine in arresting the course of continued 
fever (typhoid as it is often called) has largely accumulated 

* Dr. Fenner's Medical Reports, vols. i. and ii., published in New Orleans, 
abound -with facts fully confirmatory of the foregoing. They merit a careful 
study. 



VALUE OF SULPHATE OF QUININE IN FEVERS. 317 

during the last seven years. The testimony of Dundas, Eddowes, 
and others, to show the power of this medicine to cut short and 
prevent the accession of fever, is abundant. The work of Dr. 
Dundas on the diseases of Brazil offers many proofs. Notes of 
the success of this practice are to be found in the London Med. 
Times and other journals, from 1851 and onward. The most 
usual dose was five or ten grains every two or three hours. One 
day often sufficed for the full display of the abortive powers. 

Dr. Fenner, of New Orleans, and other Southern physicians, 
feel as confident they can cut short an attack of yellow fever by 
twenty-grain doses of the sulphate of quinine, as Dundas, Ed- 
dowes, and other foreign practitioners are that continued or 
typhoid fever can be arrested in the early stage in a similar 
manner. Let the remedy be fully tested. As to how it acts, 
whether as an antiperiodic, a sedative, antispasmodic, narcotic, 
tonic, or stimulant, that is less important than the fact that it 
does act, effectually, in aborting seizures of such diseases as 
yellow fever, typhoid, &c. &c. Ink and paper have done what 
they could to solve the question of the how, and as much more 
may be consumed ere we shall be a great deal wiser. I take it 
that this heroic medicine can and does, under various states of 
the system, display all the seemingly opposite qualities ascribed 
to it by different authors. Hence the greater need of studying 
this fundamental basis of the right use of the remedy. 

In Great Britain, France, and in various parts of the United 
States, we find abundant proof of the salutary action of the 
sulphate in all forms of typhoid fevers, whether they be desig- 
nated typhus or typhoid. Nor can there be a doubt, as all these 
fevers are more or less periodical and paroxysmal, that the salt 
of quinine should have full power over them, as it has over inter- 
mittents, if given in the early period of attack, before any con- 
siderable lesion of the bowels is set up. The establishment of 
these lesions is the only reason why this medicine does not cure 
typhoid fevers in the advanced stage. We see the same failure 
in reference to intermittents associated with the obstructions 
spoken of in a former part of this article. The typhoid fevers 
referred to are essentially and in fact remittents, and should 
yield to the great antiperiodic, if the hinderance alluded to had 
no existence. 

A writer in the Philad. Medical Examiner for September, 
1849, in criticizing the philosophy assigned by another for the 
curative action of sulphate of quinine in intermittents, maintains 
that the same remedy cures typhus and typhoid fevers as well 
as intermittents and remittents. He fails to recognize the true 
explanation, viz., that all are essentially periodical, and therefore 
curable by antiperiodic medicine. 



318 VALUE OF SULPHATE OF QUININE IN FEVERS. 

Dr. Fearne, an old and successful Southern physician, who 
practiced in Huntsville, Alabama, in 1831, speaks of the success- 
ful treatment of continued fevers, very much like what Dr. 
Bartlett calls typhoid, with twenty-grain doses of sulph. quinine 
given every half hour. The pulse fell from one hundred and 
twenty to eighty in a minute, and his patients got well rapidly. 
Fenners Reports, vol. ii. p. 347. 

Dr. Stringfellow, of Vienna, Alabama, notices a fever of con- 
siderable severity passing into the typhoid state and refusing 
to yield to all the usual means. He controlled it at last by doses 
of from thirty to fifty grains of sulphate of quinine, given every 
hour or two. The patient was only fourteen years old, and yet 
the remedy did not raise the pulse above the natural standard. 
(See BelVs Bulletin of Medical Science, vol. iv. p. 168.) 

Of the prophylactic powers of sulphate of quinine in respect 
of African fevers, which vary from a mild to a most malignant 
form of remittent, Dr. Alexander Bryson, of the Royal Navy, 
has furnished most convincing proofs. He had several pipes of 
wine prepared by adding the salt of quinine in the proportion of 
four grains to the ounce. He did this as a matter of economy, 
to save both articles : for wine, thus dosed, was held to be fit for 
nothing else, and the quinine could not be stolen in the original 
packages. Among other facts in point we have the folio wing- 
very clear statement: — " On the 25th of November seventy-seven 
men from the ship went up the river Lagos to attack the town. 
Before starting, every officer and man was ordered to take a 
glass of the quinine wine, and enough was placed in the boats to 
repeat the dose at night. All took the medicine save one young 
man, who plumed himself with having escaped taking a dose of 
physic. This young gentleman, on the 10th of December, had 
a violent attack of remittent fever, and was the only one to 
January 7th who had been seized. 

Some of our Southwestern physicians regard Asiatic cholera 
as a sort of intermittent, and these use the sulph. quinine as a 
prophylactic in one as naturally as in the other. Dr. Logan's 
authority is given on this point in Fenners Med. Reports, vol. 
ii. p. 467. Dr. Logan resides in California. 

The prophylactic powers of sulphate of quinine are strongly 
set forth by Dr. W. Balfour Baikie, formerly President of the 
Royal Med. Society of Edinburgh, in respect of African fevers. 
He cites very important facts in proof, and believes that all 
those fevers have a common origin. — Fdinb. Med. Journ., 
March, 1857. 

, Dr. Rawling urges the importance of the sulphate of quinine 
in influenza. He says by the early use of this medicine the 
cough will not acquire the same degree of violence as it will 



SULPHATE OF QUININE IN RHEUMATISM. 319 

otherwise do. The severe headache, sweating, pains of the loins 
and limbs, and the disturbed circulation, are all relieved by the 
exhibition of the medicine in grain doses every three hours. 
(See London Medical Gazette, 1833.) 

The sulphate of quinine has been employed successfully in 
the treatment of acute rheumatism. I am aware that the practice 
as well as the theory involved in this disease has been exceed- 
ingly various, nor do I know that we fully comprehend its 
pathology at this day. We are at a loss, too, in reference to 
the action of the sulphate in this disease. Yet this is not to be 
regarded a valid objection to its administration. The Phila- 
delphia Medical Examiner for November, 1848, has an inte- 
resting case of acute rheumatism in a very delicate lady, super- 
vening very soon after delivery. The report attributes the cure 
and recovery to the salt of quinine. In Braitliwaite s Retrospect, 
part xvii. p. 28, we have testimony in confirmation. Briquet 
and other French physicians have realized large success with 
this treatment; and Professor Dunglison, of Philadelphia, has 
reported favorably in the Philadelphia Medical Examiner for 
1846. He began with eighteen to twenty grains in twenty- 
four hours, and gradually increased the quantity, and affirms 
that he never witnessed any bad effect from it. Very many 
years ago the cinchonas were frequently employed in rheumatic 
disease, and the late Dr. Davis, professor of midwifery in 
University College, London, advocated strongly the use of Peru- 
vian bark in acute rheumatism. He supposed that many cases 
of this disease had considerable resemblance to ague, and he 
gave the medicine early in the attack, declaring that he was 
almost universally successful. He always preceded its use with 
free bleeding and other evacuants, but seldom found it necessary 
to repeat the bleeding; and found that under the use of the 
bark, the pains, swellings, and other inflammatory symptoms 
promptly abated. The dose was from a scruple to half a drachm 
three or four times a day. (See London Lancet, Feb. 1841. 

To some ears it may sound strange that pneumonia can be 
cured by sulphate of quinine, and yet we have the testimony of 
Drs. Corrigan, Gordon, and other respectable men, in proof of its 
successful administration in five-grain doses every three hours 
or oftener, according to circumstances. We add the inferences 
made by Corrigan at the close of his paper. 

1st. That the name of a disease is not an index to its treat- 
ment, (Dr. Rush held this to be a cardinal point,) but that, on 
the contrary, under the one name the pathological conditions of 
the organ affected may and do change so much as to call for 
even opposite modes of treatment. 



320 PROPHYLACTIC POWER OF THE SULPHATE. 

2d. That pneumonia presents an illustration of this principle, 
as it may be of a sthenic or asthenic form. 

3d. That the asthenic may be consequent on the sthenic form, 
or the primary form may be asthenic from the outset. 

4th. That quinine in large doses is a remedy of great power 
over the asthenic form of pneumonia, whether it be primary or 
secondary. — Braithivaite, xxxiv. p. 34. 

The winter fever, or typhoid pneumonia, so common in some 
of our Southern regions, has been successfully managed by Dr. 
Coolidge, of the U. S. A., with the sulphate of quinine in doses 
of ten and twenty grains. Although there was extensive inflam- 
mation in both lungs, this remedy subdued the attendant fever in 
less than twenty-four hours, and checked the progress of the 
disease. — U. S. Army Reports, 1857. 

These and like facts lie at the basis of the opinion cherished 
in the South, that there is a close relationship between pneu- 
monia and malarious fevers. 

As an offset to the dread of the contagious attribute ascribed 
to puerperal fever we are pleased to notice the prophylactic 
powers of the sulphate of quinine as announced by Dr. Leudet, 
who had abundant opportunities of testing its value in the 
Hospital of Rouen, when that disease prevailed as an epidemic. 
From September, 1843, to January, 1844, eighty-three women 
were delivered. In nine who took the sulphate of quinine there 
was no puerperal fever ; of the remaining seventy-four who did 
not take it twenty-one were seized. In 1845, of twenty-six 
lying-in women, fifteen took the medicine and only one was 
attacked, while of the eleven who did not take it eight were 
seized. In 1846, of thirty-six lying-in women, seventeen took 
the salt of quinine and only one of them had the fever, while of 
the nineteen who did not take it eleven were attacked. Five 
grains were given four hours after delivery, and the same every 
six hours for three days, when the dose was reduced. In some 
cases the medicine was given prior to delivery. (See Ranking, 
pt. viii. p. 258.) 

Traumatic tetanus has been controlled by the sulphate of qui- 
nine. M. Coste, Surgeon-in-chief of Hotel Dieu, at Marseilles, 
has given a case, in L 1 Union Medicate, of a boy aged sixteen 
who had tetanus from a wound of the toes. After bleeding, 
baths, &c. had been tried to no purpose, the salt of quinine suc- 
ceeded. Forty-five grains were given in one day, and the cure 
was complete at the end of a fortnight. 

Dr. R. B. Todd has given us cases in detail to show the value 
of sulphate of quinine in a very distressing erysipelatous affec- 
tion of the throat, in adults of various ages and conditions. The 
disease was attended with high irritation, a sense of choking, &c, 



DIARRHOEA AND DROPSY TREATED WITH THE SULPHATE. 321 

and a membranous formation was visible far back in the throat. 
The mouth could not be opened wide enough to apply nitrate of 
silver, and the chief reliance was on injections of sulphate of qui- 
nine. Ten grains diffused in two or three ounces of strong beef 
tea were administered every four hours as an enema. On the 
day after this treatment the mouth could be more easily opened 
and liquid could be swallowed. Wine, nutritious food, and the 
salt of quinine were now given by the mouth, and recovery en- 
sued. — Med. Times and G-az., June, 1852. 

While some fault-finders have charged the salts of quinine with 
the high crime of inducing urticaria, James Startin, Esq., as- 
sures the medical world that few cases of this troublesome affec- 
tion refuse to yield to the quinine preparations. This is not 
strange, for it is an old story that a game-cock, knocked over, 
apparently dead, by lightning, was made to crow as fiercely as 
ever by the action of an electrical machine. In the Medical 
Times and Gazette for May 13, 1854, we find the following 
formula, as used by Mr. Startin: — 

Jc. — Quin. disulph. grs, xij. 
Amnion, sesquicarb. gi. 
Magnes. carlo, ^ss. 
Aqua pur. ^viij. 
Mix. Dose, half an ounce three times a day. 

The quinine strength of the mixture is quite small, less even 
than a grain for a dose. The mixture is not a good one, pharma- 
ceutically speaking, and the writer should have directed the phial 
to be well shaken just before each dose was poured out. 

To relieve the itching, which, by the way, is the most trouble- 
some part of the case often, a lotion is ordered consisting of 
dilute nitric acid. Mr. S. says this is quite as effectual as the 
hydrocyanic acid, and it is less costly. 

In autumnal diarrhoea with the intermittent type, and in the 
disease called by some cholerine, as also in the diarrhoea of the 
South, sulphate of quinine has been very beneficial. The prac- 
tice most common is to give an opiate draught, followed in two 
hours by a full dose of castor oil, and, after it has operated, a 
dose of the quinine salt with small portions of iron. I have 
been, for a good while, in the habit of administering a solution of 
ten grains of sulphate of quinine in one ounce of water, adding 
enough elixir of vitriol to make the mixture decidedly sour; in 
cases of troublesome diarrhoea an adult may take a teaspoonful 
every hour. Some cases of epidemic cholera have been managed 
with large doses of the sulph. quinine, on the ground of its mala- 
rious and intermittent character. 

In the Louisville Marine Hospital, in 1852-3, I had many 
cases of dropsical effusion to treat, depending on neglected or 



322 ADULTERATIONS OF THE SULPHATE. 

badly managed intermittents, which, in a large majority of cases, 
had been of the quotidian type. The dropsy was generally most 
obvious in the lower extremities, and sometimes was in form of 
general anasarca. There was obviously great debility of the ab- 
sorbents, and often very general debility. So completely suc- 
cessful was the sulphate of quinine in such cases that it came to 
be a fixed rule for the resident students of the house to administer 
the strong acidulated solution at once, without waiting for the 
regular prescribing-day. This was kept on hand in quantity, 
as one of the standard remedies, and contained five grains to 
every ounce, enough elixir of vitriol being added to give a marked 
acid taste. In a few days there was decided improvement. 

The following formula is given in the fourth number of the 
North Amer. Medico- Chirurg . Review, p. 500, as well suited to 
remove the visceral engorgements consequent on the fevers of 
India. It is taken from the recent work of Mr. Martin, surgeon 
to the Bengal Army, on the Influence of Tropical Climates on 
European Constitutions , &c. It will be found to be a very 
energetic use of the sulphate of quinine : — 

Saturated solution of sulphate of magnesia, ^viiss ; 
Diluted sulphuric acid, |jss ; 
Sulphate of iron, 
of quinine, aa ^i. 

The dose is stated as a tablespoonful every morning, or enough 
to give two evacuations daily. Each tablespoonful will contain 
thirty grains of sulph. ferri, and as much of the quinine salt. 

The antiseptic power of the sulphate of quinine has been 
advantageously applied to arrest gangrene. For this end it has 
been given internally, and laid on the part affected in the form 
of poultice and cerate. 

Sulphate of quinine mixed with snuff has been employed as 
an errhine for the relief of facial neuralgia. But as neuralgia 
is almost uniformly a periodical disease it is quite probable that 
the relief depended on the antiperiodic powers of the sulphate 
rather than on its action as an errhine. 

The adulterations of the sulphate of quinine claim a passing 
notice. These are chiefly wheat flour, white sugar, and stearine. 
The admixture of flour is readily detected by the pasty, viscid 
quality acquired by the action of water on the mass. This fraud 
was practiced in the early history of the medicine in Philadel- 
phia, when it sold for sixteen dollars per ounce. The detection 
of sugar is not quite as easily effected. Water should be added 
to the salt, so as to dissolve the whole if practicable. Carbonate 
of potash is then added, to decompose the sulphate and throw 
down its quinine. The whole is then to be filtered, the liquor 
evaporated, and the mass digested in alcohol. If sugar be 



IS THE SULPHATE A POISON? 323 

present, it is in the filtered liquor, and "will be seen on evapora- 
tion. The alcohol takes up all the quinine which can be separated 
by evaporation. The presence of stearine is ascertained by the 
greasy sensation imparted to the fingers. 

The sulphate of quinine has also been adulterated in this 
country with mannite and sulphate of barytes, both of which are 
detected with difficulty. 

The poisonous action of the sulphate of quinine calls for a few 
remarks. When introduced to the notice of the profession in 
Pennsylvania, in 1823, it was denounced as a poison, and not a 
few so-called doctors joined in the denunciation. They refused 
to exhibit it in practice until compelled by their constant failure 
to cure the prevailing fevers by other means. At the date named 
above I gave it to children a week old and to men of threescore 
and ten with entire safety and marked success. But as eight 
grains were fully equal in power to a whole ounce of the bark, it 
is not wonderful that some untoward circumstances followed its 
administration occasionally. The quininism already spoken of 
was frequently realized by delicate females of hysterical or 
nervous temperament, and was often made a ground of objection 
to its exhibition. It consisted in confused noises in the head, 
ringing of the ears, obscured vision, a feeling of great enlarge- 
ment of the head, &c. &c. I had to contend with this difficulty, 
but did not find it an insurmountable one. It may generally be 
prevented, when the medicine is taken by the mouth, by the 
administration of twenty or thirty drops of aromatic spirit of 
ammonia every two hours for half a day before the sulphate is 
taken, or by placing sinapisms on the ankles or wrists an hour 
or two before the sulphate is exhibited. If the salt be employed 
endermically, there is far less risk of the occurrence of quininism; 
and if large doses be employed internally, the difficulty is less 
apt to be realized than if small portions be taken. 

But statements have been published, chiefly in the West, to 
show a more decidedly poisonous operation. It is stated that 
individuals have been rendered permanently deaf or blind, and 
that in one instance death followed the exhibition of the medi- 
cine. I have searched the records with some care, and feel 
justified in the assertion that ten cases of blindness or deafness, 
such as have been referred to, cannot be found in all the journals 
the world over. Some of these are probably exaggerated or 
misrepresented ; but even admitting them to be precisely as 
stated, and that twenty well-authenticated cases can be found, 
would that be a valid reason for rejecting the medicine ? If so, 
we should be compelled at once to lay aside opium and calomel 
and every efficient remedy. And if any candid man will reflect 
on the fact that millions on millions have taken the sulphate of 



324 SALTS OF QUININE. 

quinine, not once merely, but repeatedly, and in large quantities 
often, it will be matter of wonder that ignorance and rashness, 
so common to the vulgar, have not caused this very popular re- 
medy to be the occasion of as many evils as have attended the 
promiscuous and unwise use of calomel and opium. Geddes and 
Parkes, who have published some interesting facts in regard to 
the diseases of India, declare that they gave nine pounds and 
four ounces of the sulphate to twelve hundred patients sick of 
intermitting and remitting fevers. In a very few cases ringing 
of the ears followed. In two or three persons a slight amount of 
deafness ensued, but no other unpleasant effect. They exhibited 
the medicine in large doses. 

Dr. Blair says he has prescribed the sulphate of quinine to 
patients of both sexes and all ages, and frequently so as to in- 
duce cinchonism, during the last thirteen years, and has given in 
that period several thousand ounces of the medicine, without 
noticing any serious evil to result, excepting three or four cases 
of imputed abortion. — Account of the Yellow Fever of British 
Gfuiana, p. 138. 

We infer from all that is known that this medicine has such 
weighty advantages as to cast into the shade every sort of objec- 
tion ever raised against it. No wonder, when contrasted with 
mercury, which once was the Samson of the Materia Medica in 
the far South, that the sulphate of quinine should have so far 
taken its place as to be exhibited far more extensively, and suc- 
cessfully too, in the great valley of the Mississippi, than was 
ever calomel in the palmiest period of its history. We know 
prominent physicians who were formerly devoted to the mercu- 
rial practice who have almost entirely substituted the sulphate of 
quinine in its place. 

As mistakes have been made, and may be again committed, in 
confounding sulphate of morphia with sulphate of quinine, it is 
important to distinguish accurately. The labels may have been 
rubbed from the bottles, and it would not do to rely on taste or 
smell. Both salts are bitter, but one is decidedly poisonous. If 
we add a drop or two of strong nitric acid to small portions from 
each bottle, placed on a watch-crystal, the quinine salt will be 
made yellow, while the salt of morphia will be changed to a 
bright red. The experiment is performed with ease, and is suffi- 
ciently accurate for practical purposes, and every physician 
should keep the test in his mind. 

The hydroferrocyanate, the hydrochlorate, the citrate, the 
tannate, the phosphate, the arseniate, the valerianate, and other 
salts of quinine have all found favor in the profession. The first 
and last named are reported as preferable to all others, because 



SALTS OF QUININE. 325 

they do not induce quininisni. If this be so, it is an important 
recommendation. 

The hydroferrocyanate, called also ferrocyanate and Prus- 
siate, is made by boiling pure sulphate of quinine and Prussian 
blue (ferrocyanate of the peroxide of iron) in pure water and 
evaporating to dryness. The ordinary adult dose is a grain, 
given half an hour before the expected paroxysm. 

The hydro chlorate or muriate is made by saturating pure 
quinine with muriatic acid and evaporating. The dose is from 
half a grain to one grain every two hours during the intermis- 
sion. It is the most soluble salt of quinine, and hence preferred 
by some physicians. 

The citrate of quinine is made by adding to the acidulated 
citrate of soda a solution of one part of sulphate of quinine in 
forty parts of pure boiling water. The mixture is filtered while 
hot, and on cooling regular crystals appear. Eour grains are 
equal to twelve of the sulphate ; it is more agreeable to the 
stomach, and rarely gives rise to quininism. I have never em- 
ployed this salt, but believe it to be a valuable medicine. 

The tannate of quinine has been extolled by a Swedish physi- 
cian, Dr. Ronander, for agues tending to dropsy or combined 
with more or less of effusion. He combines it with black pepper, 
or piperine and wormwood. I have no doubt that in persons of 
feeble habit inclined to hemorrhage or dropsy the following pre- 
paration would be valuable : — 

R. — Tannate of quinine, 

Powder of black pepper, 
Extract of wormwood, each gss. 
Mix intimately and divide into thirty pills, giving two or three every three 
hours before the time of the expected paroxysm. 

L' Union Medicale for April 12, 1853, has an article by M. 
Delioux, showing the good effects of the tannate of quinine in 
the management of night-sweats peculiar to phthisis. He gave 
from eight to fifteen grains, divided into three or four doses, the 
whole to be taken in a day, and the last about three hours before 
bedtime. The powder may be taken in lemon syrup. 

The phosphate of quinine has been much praised by Dr. 
Harless, of G-ermany, for a reason that is popular with the 
Germans, viz., the fact of the acid combined with the quinine 
being an animal acid, and therefore more readily assimilated 
with the human economy. The dose is from one to four grains 
three times a day, and agrees well with irritable stomachs. It is 
held to be a better febrifuge and tonic than the sulphate. 

The arseniate of quinine was prepared in order to have the 
combined antiperiodic powers of arsenic and quinine. I have 
been in the habit of mixing arsenious acid and the sulphate of 



326 SALTS OF QUININE. 

quinine, and making the mass into pills, for obstinate cases of 
ague and fever. The mixture has frequently succeeded after 
both ingredients separately had failed. A fourth or an eighth 
of a grain of the arsenious acid may be given with the dose of 
the sulphate three times a day, the last medicine being employed 
also in the intervals alone. Those who prefer to have the 
arseniate of quinine ready for use can obtain it of the best 
apothecaries. 

The valerianate of quinine is supposed to be suited to the 
cases of persons of a decidedly nervous temperament, and is 
believed to have the important advantage of exciting no sort of 
cerebral disturbance. 

The following preparations of quinine may be administered 
very usefully in glycerine, as it dissolves them entirely : — one 
grain and a half of the sulphate to one drachm of the glycerine ; 
a clear fluid of a beautiful straw color and intensely bitter taste 
is the result. One grain of the iodide will dissolve in one 
drachm, giving a beautiful amber-colored mixture, very bitter 
and clear. Five grains of the citrate of quinine and iron will 
dissolve in a drachm of the glycerine ; the fluid, which is opake, 
has a greenish-yellow color and a strong metallic or styptic taste. 
— American Druggists' Grazette, July, 1857. 

Some interesting experiments have been reported to show the 
real therapeutic action of the preparations of quinine. These 
have sometimes been of such a nature as to make the impression 
that the medicine was a direct sedative ; sometimes they would 
lead us to regard it as a stimulant. My own opinion, as may be 
gathered from what has been already said, is that it may prove 
stimulant or sedative, according to the condition of the organ on 
which it acts directly or the state of the general system. This 
view will be found to be correct by observant practitioners, or I 
am greatly mistaken. 

The effect of sulphate of quinine on the 'pulse has been very 
particularly noticed by several acute observers. The pulse has 
fallen under its use from 140 to 84 in seventy-six hours, and from 
104 to 72 in twenty-four hours, thus justifying the appellation of 
sedative to the remedy. The cases of Dr. Fearne, reported in 
Fenners Medical Reports, vol. ii., show that under twenty-grain 
doses every half hour the pulse fell from 120 to 80. In other 
conditions the medicine has acted as a stimulant and irritant. 

It is also antiseptic, and most assuredly it is the very best 
antiperiodic ever known or likely to be known to the profession. 
Its power as a tonic is also unquestionable, though some think it 
inferior, as such, to the Peruvian bark. We can readily aug- 
ment its tonic and antiperiodic powers by combination with 



CINCHONISM — CINNAMON. 327 

sulphate of iron or sulphate of copper, as I have frequently 
done. 

Very many substitutes have been offered to the public, though 
none are equal to the sulphate of quinine. The Parthenium In- 
tegrifolium, or Prairie Dock of the West, is among the more 
recent. — New York Medical Gazette, Jan. 1853. 

Cinchonism. — This term is used synonymously with quinin- 
ism, and refers to the ringing of the ears, some deafness, an 
imaginary sense of sivelling of the head, and other cerebral 
symptoms that sometimes follow the exhibition of the salts of 
quinine. My experience warrants the assertion that these symp- 
toms come on after the use of small doses more frequently than 
after very large ones have been given. Some persons never 
realize them at all, and they are transient, when they do occur, 
almost uniformly. 

But cinchonism is not peculiar to quinine medicines. Salicine, 
Angustura bark, and bebeerine have induced it. As a general 
rule it does not last longer than twenty-four hours. As noticed 
elsewhere, the best preventive is the aromatic spirit of ammonia, 
ten to twenty drops every two hours, and sinapisms to various 
portions of the extremities. 

Cinnamon. Cinnamomi Cortex. Bark of the Laurus Cin- 
namomi. — This is one of the articles that calls for no description 
here, as everybody knows what it is sufficiently well ; nor do 
I intend to say much about its medicinal uses. The strongly 
aromatic and spicy article is of course the best for all purposes. 

The powder of cinnamon is a good adjunct to less agreeable 
medicines, and is often employed in that relation. The decoc- 
tion or tea is often useful to relieve pains of the stomach and 
bowels caused by flatulence. It is hence called an antispasmodic 
and carminative as well as a stimulant. An ounce of coarsely- 
bruised bark may be added to a quart of boiling water, and 
simmered in a covered vessel for ten minutes. A much stronger 
decoction is often serviceable as a fomentation to the abdomen, 
especially in the cases of young children. The spice plaster 
was a very favorite application in cholera infantum in the hands 
of the late Dr. Parrish. It is made by incorporating with 
melted suet the fine powder of cinnamon and all other spices 
that are at hand. The whole is well mixed and spread on leather 
or linen, and renewed twice in twenty-four hours. It gives some 
support to the bowels, and is gently stimulant to the surface, 
sometimes proving rubefacient. The oil of cinnamon mixed 
with sweet oil, gently heated and rubbed into the spine at bed- 
time, will frequently calm a fretful child laboring under colic 
pains and put it to sleep. Ten drops of the aromatic oil may 
be added to a teaspoonful of sweet oil for this end, and we may 



328 CLIMATE. 

increase the rubefacient power by adding ten drops of liquid 
ammonia. 

Climate. — Various writers have considered climate as a power- 
ful therapeutic agent, sometimes prompt, but more frequently 
gradual in its operation. We cannot do better than to quote at 
length the judicious remarks of Mr. Copland, in his Library of 
Practical Medicine, on this point : — 

"Of change from a cold or temperate to a warm climate. — 
Keeping in view the following characteristics of a cold and tem- 
perate climate, viz., its low temperature, the alternation of 
seasons, the pureness of the atmosphere, the more nutritious, in- 
vigorating, and stimulating nature of the food, and the effects of 
warm clothing ; and connecting these with the vascular plethora, 
the active functions of the brain, lungs, liver, and kidneys of its 
inhabitants, the disturbances which will result when they are sub- 
jected to a continued high range of temperature and to an atmo- 
sphere loaded with moisture, and frequently with vegeto-animal 
effluvia, may be anticipated. It is now fully ascertained that 
the effects of a high range of temperature and of moist miasmal 
air on the European constitution are a diminution of the changes 
effected by respiration on the blood, an increase of the secreting 
and excreting functions of the liver and skin, and a decrease of 
the urinary excretion. When, therefore, the plethoric European 
migrates to an intertropical country, the functions of the lungs 
and the pulmonary exhalation become diminished ; the requisite 
changes are not effected on the blood, notwithstanding the ex- 
citement of the nervous and vascular systems by the increased 
temperature ; and the already active and developed liver is irri- 
tated, and has its functions augmented, by the increase of those 
elements in the blood that the lungs and skin cannot remove from 
it. Hence proceed febrile attacks, particularly when excited by 
their appropriate causes ; inordinate activity, with a relative fre- 
quency of the diseases of the liver ; the secretion of acrid bile ; 
and the disorders especially affecting the alimentary canal and 
excreting organs. The general adoption of too rich and nourish- 
ing food and beverages by those who remove from cold to hot 
climates tends greatly to increase these evils, as already ex- 
plained ; and the influence of high temperature and of a vertical 
sun upon the European head is productive of disease both of it 
and of the liver. To these effects the mental cultivation and 
activity of Europeans somewhat predispose them, whilst their 
heads are not so well guarded from external influence by the 
constitution of its integuments and hair, and the thickness of the 
cranial bones, as those of the negro and Mongol varieties of our 
species. 

" The obvious indications resulting from these facts are that 



CLIMATE. 329 

natives of cold countries migrating to warmer climates should, 
particularly if the change has been made abruptly, live abste- 
miously, and promote the functions of those organs which per- 
form the most essential part in excreting effete or injurious ele- 
ments from the circulation. The head should be kept cool, and 
protected from the rays of the sun ; the surface of the trunk 
and lower extremities ought to be preserved in a freely perspi- 
rable state, so as to take off the load of circulation, and derive 
from the excited liver. In order to promote the secreting and 
depurating functions generally, active exercise, short of fatigue, 
should be taken, without exposure to the causes of disease, par- 
ticularly those which are endemic. As the maladies which most 
frequently supervene on change from a cold to a warm climate 
proceed neither from the increased temperature alone nor from 
greater moisture of the air, but from these conjoined with 
malaria, and not unfrequently also with wide ranges of tempera- 
ture during the twenty-four hours, especially in high and inland 
localities, with hot days and cold, raw, and dewy nights, and 
with a too full and exciting diet and regimen, causing fevers, 
dysentery, and diseases of the biliary organs, care ought to be 
taken to avoid those causes, as well as whatever may tend to 
assist their operation on the frame, and to protect the system 
against the sudden daily changes by warm clothing at night, &c. 
" The consideration of the effects produced by migration 
diwing a state of disease, from a cold to a warm and moist 
climate, is of the utmost importance. Keeping in mind its in- 
fluence upon the healthy frame, chiefly in exciting the functions 
of the skin and liver and diminishing those of the lungs, we are 
led to prescribe it in the treatment of various diseases. In 
hcemoptysis this change is obviously beneficial, especially as a 
warm and moist atmosphere, by this mode of operation, lessens 
the activity of the pulmonic circulation and the disposition to 
sanguineous exudation from the surfaces of the bronchi. Bron- 
chitis and tubercular phthisis are also often benefited, and the 
progress of the latter much delayed, by this state of atmosphere, 
especially when adopted early. Chronic rheumatism is some- 
times cured by this change, seemingly owing to its influence in 
promoting the biliary and cutaneous functions. Dropsies, par- 
ticularly anasarca and hydrothorax, have been, in a few instances, 
removed by a change to a warm climate ; but while a moist 
state of the air is most serviceable in pulmonary and hemorrhagic 
diseases, dry warmth seems more beneficial in dropsies, dyspeptic 
affections, and hypochrondrasis, evidently from its effects in aug- 
menting the insensible perspiration and the pulmonary exhalation 
and imparting tone to the capillary circulation. Besides these, 
gout, in its early stages, dysmenorrhoea, and scrofula in nearly 

22 






330 CLIMATE. 

all its forms, are benefited by a change to a warm, or even a mild 
and dry atmosphere. 

" Of migration from a ivarm to a cold or temperate climate. — 
This subject should be viewed in relation, first, to the change as 
it affects the dark races of man ; and secondly, as it respects 
those belonging to the Caucasian variety who have either been 
born or acclimated in warm countries. If change from a cold to 
a warm climate is productive of disease and great mortality in 
the white constitution, the migration of the dark races to a cold 
or temperate country is not less fatal to them ; and while the 
change produces in the former case fevers, diseases of the biliary 
organs and of the alimentary canal, it occasions in the latter 
tubercular phthisis and other tubercular affections, with diseases 
of the bronchi, &c. When the dark races, particularly the negro 
and those of the Mongol variety, who are natives of intertropical 
and low countries, migrate to places subjected to a low range of 
temperature during a great part of the year, the depressing in- 
fluence of cold upon the nervous system and vital actions of the 
lungs and skin gives rise not only to tubercular formations, but 
also to increased secretion from the internal mucous surfaces, and 
they are in the great majority of cases cut off in a few months 
or years by diseases of the lungs, kidneys, and bowels. Those, 
however, who change the climate progressively, or who are born 
in countries of an intermediate temperature, and who are pro- 
vided with warm clothing and animal or nutritious diet, suffer 
much less than those who migrate in a more direct manner, even 
although possessed of these latter advantages. The native 
African who removes immediately to Europe seldom lives over 
two winters in it ; while the negro who has been brought to the 
West Indies, and subsequently to the Southern States of North 
America, previously to his arrival in more northern countries, 
and enjoys necessary food and clothing, will often not suffer ma- 
terially from the change. 

" Those who have been born of European parents, or been 
seasoned in warm climates, not infrequently suffer after removal 
to temperate or cold countries. Even although the change may 
have become necessary from chronic affections of the liver or 
bowels, yet may it for a while aggravate or render more acute 
hepatic disorder, or superadd to it disease of the lungs ; and 
many who have experienced only functional disorders of the 
stomach or liver, or who acquired merely a tendency to them 
during their residence within the tropics, have been attacked by 
active diseases soon after their return to Europe. Others, also, 
who have suffered more seriously, have had their complaints 
aggravated after a short residence in England, although they 
were benefited during their voyage home. This result of change 



CLIMATE. 331 

to a colder climate proceeds not, however, altogether from the 
temperature or the state of the seasons, but in a great measure 
from the imprudence of the patient. Frequently, however, a 
colder atmosphere is prejudicial for a time, by constricting the 
vessels on the external surface and determining an increased 
flow of blood to the large internal viscera, and thereby occasion- 
ing congestion and obstruction of those organs which have been 
weakened by previous disease or the influence of climate. An- 
other frequent consequence of change from a warm to a cold 
country is a diminution of all the secretions, particularly those of 
the skin and liver ; originating vascular plethora and visceral en- 
gorgement. In this state pf the vascular system, if the cuta- 
neous or pulmonary surface be subjected to cold, particularly cold 
combined with moisture, after the circulation has been determined 
to these parts by hot rooms and crowded assemblies, or if re- 
action rapidly follow the impression of cold, the great mass of 
blood is thrown upon the internal viscera, which, if not relieved 
by a free secretion, becomes the seat either of congestion or of in- 
flammation. Hence it is that hepatitis or dysentery so frequently 
follows changes from a high to a low temperature. The remark- 
able liability to diseases of the respiratory organs observed in 
those who have returned to Europe after a long residence in 
warm countries is evidently owing, in many instances, to pre- 
existing disorder of the liver, which has extended thence to the 
lungs, owing either to the increased action of this latter organ 
upon removal to a colder climate, or to imprudent exposures to 
cold, or to breathing a very warm and close air immediately upon 
coming out of a cold and dry atmosphere. 

" In order to counteract these effects of change, warm clothing, 
particularly of the lower extremities, with the use of flannel next 
the skin, should be adopted ; and exposures to cold and moisture 
and the night-air be avoided. The diet ought to be light, and of 
moderate quantity ; the strong wines imported into this country 
abstained from; and, above all, the functions of the bowels and 
abdominal viscera carefully watched and promoted whenever they 
seem to flag. It may be of importance to know the most suitable 
period of the year to arrive in this country, after the frame has 
become assimilated by a long residence to a warm climate. If 
an invalid return in winter, the sudden transition from a warm 
to a cold country may be detrimental ; if early in the spring, he 
is liable to feel the effects of a variable season for some time. 
The least objectionable period extends from May to September ; 
and if the cold of the winter months be found too severe in the 
more easterly counties, or in the metropolis, the climate of 
Devonshire or of Bath may be tried with as great advantage as 
that of most of the southern parts of continental Europe. Old 



332 CLIMATE. 

residents in a warm climate will experience much advantage from 
residing sometime in the more southerly parts of Europe before 
passing to England or other countries of the north, more par- 
ticularly if they use a course of the warm mineral waters of 
Vichi, Carlsbad, or Ems, in their way. 

"The children born of white parents resident in the more un- 
healthy countries within the tropics very generally die at an 
early age if they be not removed to a colder climate. They 
commonly sink from the choleric form of fever, described in a 
separate article as incidental to infants, or from diarrhoea, dysen- 
tery, or diseases of the abdominal secreting viscera, often assum- 
ing a remittent form. When, therefore, either of these appears 
in this class of patients, removal to a temperate climate should 
be advised when it can be effected, taking care to guard them by 
warm clothing, &c. from vicissitudes of temperature for a con- 
siderable time after the change, and attending to the first indica- 
tion of pulmonary or tubercular disease, or disorder of the liver 
and bowels. 

"We are next to speak of the therapeutic action of climate, 
as seen in certain localities, and we shall notice, first, the climate 
of certain places in England. The chief difficulty in this coun- 
try is to find a mild and sheltered climate for invalids, from 
pulmonary disease, and it is almost exclusively to the south and 
southwest parts of the island; in the immediate vicinity of the 
sea, that we must direct our inquiries. The general use of coal 
fires in all the large towns in Great Britain, owing to the quantity 
of sulphur this mineral contains and of sulphuric acid fumes and 
fuliginous matter generated, renders the air more irritating to 
the lungs, and increases the risk of a winter residence in these 
places to all those who suffer from or are even liable to diseases 
of the respiratory organs. This, together with other considera- 
tions, especially the results of observation, renders it imperative 
on the medical attendant to recommend removal to a more salu- 
brious locality. The mild situations I shall notice are in the 
south, the southwest, and the west of the island. 

"The south coast is much milder and more moist than the east 
and inland parts of the island during the months of November, 
December, January, February, and March; but from April till 
October, the temperature of the latter is greater. On this part 
of the coast, Undercliff, in the Isle of Wight, Hastings, and 
Brighton have been recommended as winter residences for in- 
valids. Undercliff is the most sheltered and milcl of these places 
in winter, and its air softer and more humid in summer, than 
either. Hastings is sheltered during the winter and spring 
months from the north and northeast winds, and, of the various 
places on this part of the coast, ranks next to Undercliff as a 



CLIMATE. 333 

residence for invalids with pulmonary affections. Brighton is 
more exposed than the foregoing to the north and northeast 
winds, and its air is drier and hence more bracing. It is, there- 
fore, more suitable than they to the nervous, the simply debili- 
tated and relaxed, to the dyspeptic, to those affected with chronic 
bronchitis and asthma attended by greatly-increased secretion. 
Dr. Clark very properly suggests that invalids who select the 
south coast as their winter residence should pass the autumn at 
Brighton and the winter at Hastings, the climate of the former 
being mild to the end of December. 

"The southivest coast of the island is very mild in several 
situations during the winter, and has, therefore, been very gene- 
rally recommended in diseases of the respiratory organs. Sir 
J. Clark estimates the temperature of its more sheltered locali- 
ties as being 5° higher than that of London during the winter 
months; and the temperature of the south coast as only 2° 
higher. But I conceive that there are at least 6° and 3°, re- 
spectively, of difference between these and London and its 
vicinity. Besides, it is not only the range of temperature that 
should be considered, but its greater equality and less rapid 
vicissitudes, and the increased humidity and more soothing in- 
fluence of the air. The places on the coast of Devonshire most 
in repute as residences for the consumptive are Torquay, Daivl- 
ish, Sidmouth, JExmouth, and Salcombe. Of these, Torquay is 
the best, and, according to the reports of Sir J. Clark, Dr. 
Foote, and of my friend Dr. W. Hutchinson, who has resided in 
it, superior to all other places in our island in pulmonary cases. 

" Penzance is the principal place in Cornwall recommended 
for invalids. Its peninsular situation and southwest position 
give it a remarkably soft, humid, and mild atmosphere ; and the 
equality of its temperature, not only throughout the year, but 
also during the day and night, renders its climate in many re- 
spects superior to that of most places in the south of Europe, 
and brings it next to Madeira. The quantity of rain that falls 
annually at Penzance is nearly double that which falls in London ; 
the number of rainy days is much greater, and the temperature 
of the air at night at least 7° higher during the winter months. 
This mildness, equality, and humidity of climate is, however, 
somewhat impaired by its exposed situation and its liability to 
high winds. 

Both the Land's End and the coast of Devonshire, owing to 
the predominating character of softness, humidity, and equality 
of climate, exert, along with a soothing, an evidently relaxing 
effect. Hence this coast is best suited to the irritable and in- 
flammatory states of disorders of the respiratory organs, and 
such as are characterized by irritation, with little expectoration 



334 CLIMATE. 

and dryness of skin. In cases attended with a copious expecto- 
ration, great relaxation of the mucous surfaces and soft solids, 
and in nervous debilitated persons, this climate will prove in- 
jurious. Even in those cases where it is evidently indicated, and 
actually proves of service, removal will be necessary to a some- 
what drier air during the summer ; and this should not be de- 
ferred longer than June, or undertaken before April or May; 
the patient generally deriving much benefit by returning the 
succeeding winter. The observations now made upon the climate 
of the southwest coast apply to that of Jersey and Gf-uernsey, to 
which islands invalids sometimes repair, and occasionally with 
advantage. Southwest winds generally prevail in them during 
autumn and winter, and cold northeast winds often continue long 
in the spring. The summer climate of these isles is excellent. 
Of the two that of Jersey is preferable. 

"The West of England. — The mean temperature of this part 
of the island is a little lower than the southern coast, but in 
March and April it rises somewhat above it. Bath and Bristol 
are about 3° warmer than London during the months of Novem- 
ber and December; but this difference is reduced more than one- 
half during January, February, and March. In this part of the 
country the vale of Bristol is the most sheltered and mildest. 
The climate during the winter is rendered more mild by the 
vicinity of the ocean, while the groups of surrounding mountains 
attract the clouds and diminish the fall of rain below the current 
to which its western position would otherwise subject it. Bristol 
Hot-wells and the lower parts of Clifton are the most sheltered 
spots, and the best suited to consumptive patients, while other 
invalids will find most advantage in the more elevated situations 
which the latter presents. In general, the climate of this place 
is, perhaps, the mildest and driest in the west of England, and 
therefore one of the best winter residences for invalids. It is 
drier and more bracing than that of the southeast coast, and 
therefore not so well suited to consumptive cases and to those 
affected by irritative action in the respiratory passages and 
bronchi. For these the more soft and humid air of Torquay 
and Penzance is preferable ; but, with the return of summer, the 
consumptive invalid will relinquish the latter for the former with 
benefit. Clifton and Bath are certainly preferable places of 
residence to the southwest coast, in cases of protracted dys- 
pepsia, gout, and scrofula, particularly the last, occurring in 
young persons, and relaxed habits. In these affections, the 
waters of Bristol Hot-wells will, with regular exercise on horse- 
back or on foot, prove extremely beneficial. 

"The more inland districts of this part of England furnish 
various places which are salutary to invalids during the summer. 



CLIMATE OF FRANCE. 335 

Malvern and the surrounding country, with the Malvern waters, 
are very serviceable in scrofulous and dyspeptic cases ; and for 
the consumptive and other invalids various places in Wales, as 
Abergavenny, Aberystwith, Tenby, Barmouth, &c, will be visited 
during the season with advantage. Where a course of goat's 
whey may be considered of advantage, a summer residence in 
Wales will be preferred. There are various other places which, 
besides their mineral waters, furnish excellent summer residences 
for the invalid. Buxton, Matlock, Leamington, Cheltenham, 
Tunbridge Wells, &c, independently of the use of their respective 
mineral waters, prove excellent places of residence for those who 
are debilitated or exhausted, whose mucous surfaces are relaxed, 
or whose digestive, secreting, and assimilating functions are im- 
perfectly performed, and any of the abdominal viscera congested 
or obstructed. In these latter circumstances of disease espe- 
cially, the appropriate use of the waters of those places, assisted 
by regular horseback or walking exercise, by suitable medical 
treatment, and by mental relaxation and amusement, will often 
prove of great service. In prescribing the mineral waters of 
any of those places, due reference should be had to the nature 
of the climate; and, on the other hand, when directing change 
of climate, some attention should be paid to the waters which 
the place may afford, as the appropriate use of the one while 
the patient is experiencing the influence of the other will ma- 
terially promote the end in view. 

"In a very great proportion of cases where the state of the 
patient admits of change of locality much advantage will accrue 
from passing the autumn on the south coast of the island, as at 
Brighton, Hastings, or Undercliff, after having passed the sum- 
mer at the foregoing watering places. In general, when the 
digestive and generative organs are disordered, frequent change 
of air, and traveling by easy and short journeys, with gentle 
exercise, particularly on horseback, agreeable amusement, and 
regular habits, will prove of marked advantage, and greatly aid 
medical treatment. 

" Of the, climate in certain parts in France. — The West and 
Southwest of France furnish several places the climate of which 
possesses the softness and humidity which are requisite in pulmo- 
nary diseases. The mean annual temperature of the southwest 
of France is stated by Sir J. Clark to be 4° higher than that 
of the southwest of England ; and the climates of both generally 
agree or disagree with the same diseases. That of the south 
coast of Brittany is mild during the winter and temperate in 
summer, the mean temperature of this province being about 
56 J°. Its climate is soft and relaxing ; and it is hence suited to 
dry bronchial irritations, to hsemoptysis, and tubercular cases. 



336 CLIMATE OF FRANCE. 

Laennec found it very favorable to consumptive patients, and 
states that the proportion of such in this part of France is very 
small. In scaly eruptions on the skin, dysmenorrhoea, and in 
irritable habits of body, this climate will be often of service. 

"Pan, situated at the base of the Pyrenees, from the account 
of it given by Dr. Clark and Dr. Playfair, appears to be the 
best place in the southwest of France for invalids ; and yet in 
no respects is it superior to the southwest of England in consump- 
tive cases. Its air is still and mild in winter and spring; the 
chief advantage it offers being the great mildness of its spring. 
Dr. Clark gives the following comparison: — 'Its mean annual 
temperature is 4J° higher than that of London, and about 3° 
higher than that of Penzance ; it is about 5° lower than 
that of Marseilles, Nice, and Rome ; and 10° lower than that of 
Madeira. In winter it is 2° warmer than London, 3° colder 
than Penzance, 6° colder than Nice and Rome, and 18° colder 
than Madeira. But in the spring Pau is 6° warmer than Lon- 
don and 5° warmer than Penzance, only 2J° colder than Mar- 
seilles and Rome, and 7° colder than Madeira. The range of 
temperature between the warmest and coldest months at Pau is 
32° ; this at London, and likewise at Rome, is 26° ; at Penzance 
it is only 18°, and at Madeira 14°. The daily range of tempera- 
ture at Pau is 7J° ; at Penzance it is 6J° ; at Nice 8J°; and at 
Rome 11°. Pau is drier and warmer than the south part of 
England in the spring, and northerly winds are less injurious. 
One of its chief advantages is its vicinity to the watering places 
among the higher Pyrenees, which are often beneficial places of 
summer residence to those who have passed the winter and spring 
at Pau.' 

" The Southeast of France. — The climate of the tract of 
country extending along the shores of the Mediterranean, from 
Narbonne and Montpelier to the Var, is warmer and drier, but 
more exciting than that of the southwest. It is subject to sud- 
den vicissitudes of temperature and to cold winds, especially 
the northwest, or Mistral. It is decidedly prejudical to con- 
sumptive patients, especially when the disease has made some 
progress, and to irritative affections of the stomach, trachea, or 
larynx ; and is serviceable chiefly in diseases of debility and 
relaxation unattended by inflammatory or hemorrhagic action. 

" Sir J. Clark ranks the principal places on the coast of Pro- 
vence in the following order as residences for invalids : Hyeres, 
Toulon, Marseilles, Montpelier, Aix, Nismes, Avignon. Hyeres 
possesses the mildest climate on this part of the coast, being 
sheltered from the north winds by a range of hills, and its 
inhabitants being comparatively exempt from pulmonary affec- 
tions. At Marseilles the climate is dry, variable, and subject 



CLIMATE OF ITALY. 337 

to cold, irritating winds. It is, therefore, injurious to consump- 
tive patients ; and is one of the places in France where pulmo- 
nary diseases are most prevalent. Invalids requiring a dry air, 
and capable of bearing cold winds, may be benefited by resid- 
ing here for some time. Montpelier has obtained a reputation 
for salubrity to which it has no claims. According to MM. 
Fournier and Murat, more than a third of the deaths that occur 
in the hospital of this city are from pulmonary consumption. 
The prevalence, in this part of the country, of northerly winds 
during winter and spring, both accounts for the frequency of 
pulmonary diseases and points out its unfitness as a residence 
for patients thus affected. Aix is still more exposed than 
Montpelier to the Mistral and north winds, and pulmonary com- 
plaints are very prevalent among its inhabitants. 

" Nice, although situate on the same line of coast as Provence, 
enjoys a much milder climate than any part of that province. 
It is protected, by a lofty range of mountains, from the north 
winds ; and the daily range of temperature is there less than at 
almost any part of the south of Europe. During winter the 
weather is settled and the atmosphere clear, the thermometer 
seldom sinking to the freezing point excepting at night. At 
this season, however, as well as in the spring, cold, dry winds 
are not unfrequent ; and the climate is, upon the whole, dry 
and exciting. Hence it is not favorable to pulmonary consump- 
tion, the very disease for which it was formerly very improperly 
recommended. It is likewise unfavorable to irritable or inflam- 
matory states of the larynx, trachea, and bronchi, attended with 
scanty expectoration or haemoptysis. But chronic bronchitis, 
bronchorrhcea, and humoral asthma are generally very much 
benefited by the climate of Nice. It is also serviceable in all 
cases of debility, torpor, and relaxation of the mucous surfaces ; 
in chronic rheumatism, gout, external scrofula, dyspepsia, and 
hypochondriasis. 

"Of the climate of Italy and the Mediterranean. — G-enoa is 
not favorably noticed by Dr. Clark as a residence for invalids ; 
but Dr. Johnson, on the authority of Dr. Mojon, speaks of it in 
more favorable terms. It is best suited to those affected by 
chronic bronchitis and dyspeptic and gouty complaints, and to 
persons of relaxed and phlegmatic habits of body. Pisa, Rome, 
and Naples are the other places in Italy most frequented by 
invalids. The climate of Pisa nearly resembles that of Rome, 
the latter being somewhat warmer and drier in winter. Dr. 
Clark considers the climate of Rome as one of the best in Italy 
for consumption unattended by haemoptysis. For those, how- 
ever, who cannot take exercise in the open air, and must confine 
themselves to sheltered situations, the Lung Arno, in Pisa, is the 



338 CLIMATE OF THE NORTHERN ATLANTIC. 

best place of residence to be found in Italy. The climate of Na- 
ples is considered by this writer, as well as by M. Lasnyer, more 
exciting than that of the two foregoing places ; and it is more 
subject to high winds. The diseases which a residence in either 
of these three cities will benefit are those above enumerated. 
Persons who remain in Italy during the summer will find Lucca, 
Sienna, and the vicinity of Naples, the coolest situations. 

u There are various other places on the shores and islands of 
the Mediterranean the climates of which are suitable to invalids ; 
but we possess little or no accurate information respecting them. 
Malaga, in the south of Spain, Cagliari, in Sardinia, and some 
parts on the coast of Sicily, afford a mild winter climate, but the 
difficulty of reaching them and of obtaining in them many neces- 
sary comforts and conveniences almost precludes invalids from 
the northern part of Europe from visiting them. Malta is hot 
open to these objections ; but, according to Dr. Hennen, the 
quantity of dust raised from its arid soil and suspended in the 
air during dry weather renders it an unsuitable climate for con- 
sumptive patients. A considerable number, also, of the inhabit- 
ants die of pulmonary diseases. In his work on the medical 
topography of the islands of the Mediterranean, Dr. Hennen 
states a fact which is perfectly in accordance with my observa- 
tion in warm climates, although doubted by Dr. Clark, viz. : that 
those of the Ionian Islands which are decidedly most malarious 
and remarkable for remittents have had fewest pulmonale affec- 
tions among the British troops. In respect of the health of 
the troops stationed in these islands, this writer states that from an 
average of seven years, phthisis has borne a proportion to other 
complaints of one to one hundred and ninety-eight and a quarter 
only. At Malta, on an average of eight years, consumption has 
occurred in the proportion to other maladies of one to ninety- 
three and a half. Including all pulmonic complaints whatever, 
the proportion to others, as regards the Ionian Isles, has been 
one to twenty and three-quarters ; and, as respects Malta, one 
to fourteen. Taking into calculation the whole Mediterranean 
islands, the proportion of pulmonic to other diseases has been one 
to seventeen and a quarter in the British army. 

u Climate of the Northern Atlantic. — Under this head the cli- 
mates of Lisbon, Cadiz, Madeira, the Canaries, the Azores, 
Bermudas, and the Bahamas, may be arranged; all of which 
have been recommended to persons requiring a soft and equable 
climate during the winter and spring. 

" Madeira is, of all these places, indisputably the best as re- 
spects both the climate and the comforts and conveniences 
within the reach of the invalid. The frequency and excellency 
also of the means of conveyance to and from the island are no 



CLIMATE OF THE NORTHERN ATLANTIC. 339 

small recommendations. From the minute account furnished of 
the climate of this island by Drs. Gourlay, Heineken, and Ren- 
ton, after a long residence in it, and from the effects I have 
observed in several persons who have resorted to it as a winter's 
residence, it may be justly concluded that it is superior to any 
part of the south of Europe for consumptive cases. Its central 
ridge of mountain gives it in summer a cool land wind ; and the 
north trade winds at this season renders it temperate and salu- 
brious. During winter and spring, Funchal and parts near the 
sea-shore are the best places of residence ; and during summer 
the more elevated situations in the interior are cool and agree- 
able. The mean annual temperature of Madeira is about 6° 
higher than the southeast of France and Italy ; and the heat 
throughout the year is much more equably distributed. The 
winter of the former is 12° warmer than that of the latter, and 
the summer 5° colder. At Madeira, the extreme annual range 
is only 14°, whilst it is double this amount at Pisa, Rome, and 
Naples. In respect also of the progression and steadiness of 
its temperature, it excels those places. Rain falls at Madeira 
on seventy-three days of the year, and at Rome on one hundred 
and seventeen days, and chiefly during the autumn in the former. 
The aii- is also more soft than at Rome. 

" The Canaries possess the next best climate to Madeira. 
The mean annual temperature, however, of Santa Cruz, the capi- 
tal of the former, is 71° ; while that of Funchal, the capital of 
the latter, is only 65°. The summer temperature of Santa 
Cruz is 7° warmer than that of Funchal, and the winter tem- 
perature 5° warmer. Hence the mean annual range of tempera- 
ture is greater in the Canaries than in Madeira, which pos- 
sesses, in other respects, advantages sufficient to recommend it 
in preference to the former in pulmonary diseases. 

" The Western Islands, or Azores, enjoy a climate nearly ap- 
proaching that of Madeira. They are, however, more subject to 
high, raw winds, particularly those from the north and north- 
west, which are often very cold and harsh ; and the temperature 
of winter is lower and that of summer higher than in Madeira. 
The air is also more humid. From a very short visit'I made to 
Madeira and the Azores — to the former in the spring and to the 
latter in winter — I should conclude the Azores to be much inferior 
to Madeira as a residence for invalids, chiefly because of the ab- 
sence of the many necessary comforts and conveniences of their 
stormy winters, and the infrequency and ineligibility of the oppor- 
tunities of transport between them and this country. The cli- 
mate of the Bermudas and Bahamas presents no advantages 
sufficient to obtain for them a preference to those already noticed. 



340 SEA-SHORE RESIDENCE. 

They are liable to storms and to harsh northerly winds in winter, 
from the American coast, while their summers are very hot. 

" Climate of the West Indies. — The mean annual temperature 
of the West Indies at the level of the sea is 79°, 80°, and 81°; 
and during the winter months in some places about 3° and in 
others only 2° lower. The extreme annual range is 20°, and 
the mean daily range about 6°. This continued high tempera- 
ture exhausts the energies of invalids ; and the clearness of the 
skies and great power of the sun prevent suitable exercise in 
the open air. A visit to the West Indies of a few months' dura- 
tion, made either to some of the most healthy islands or passed 
chiefly aboard ship, will, however, prove of service in several 
chronic affections, particularly those referred to above, excepting 
consumption in its most advanced stages. Persons much disposed 
to this disease, either hereditarily or by the conformation of the 
chest, &c, or who are threatened by its early stages, will find a 
removal to the West Indies one of the prophylactic measures 
most to be depended upon. When residing some time in an ex- 
tremely malarious place within the tropics, I observed that the 
most healthy persons in it were those who were constitutionally 
disposed to pulmonary disease. But I believe that the observa- 
tion often made is perfectly correct, that removal to an intertropi- 
cal country when phthisis is far advanced will only accelerate 
its progress. It may also be stated that severe and protracted 
catarrhs are very common upon entering between the tropics. 
In gout, chronic rheumatism, scrofula, and calculous affections, a 
residence in the West Indies is often productive of advantage. 

" Of residence on the sea-shore and voyaging. — There are 
certain topics connected with change of climate often discussed 
during the course of practice, viz., whether are inland situations, 
or places on the sea-shore, whose climates are physically alike, 
most serviceable in pulmonary diseases ? and whether or not sea- 
voyages possess any advantage over a land residence in these 
complaints ? In respect to the first question, it may be stated 
that places on the sea-shore are generally more humid than 
those inland, and oftener, on this account, preferable in the dry 
and the hemorrhagic pulmonary affections ; while a situation 
somewhat inland, or not removed above a few miles from the 
coast, seems somewhat more serviceable in those cases of con- 
sumption which are otherwise characterized. But the question 
has not been satisfactorily determined, and, indeed, is not easy 
of solution. 

"With reference to the second question, it may be stated more 
confidently that sea-voyaging, in a suitable climate, is preferable 
to land residence in the early stages of phthisis, and particularly 
when it is attended by hemoptysis. This advantage is evidently 



INJECTIONS. 341 

to be attributed to the influence of the ship's motion on the san- 
guineous and nervous systems. This opinion was argued for by 
Dr. Gregory, in his excellent thesis Be Morbis Qoeli Mutatione 
Mendendis, and has been generally admitted. Cruising in a 
warm, or even temperate latitude, particularly in the Atlantic, 
is preferable to voyaging because of its longer duration. While 
the sun is north of the equator, the climate between the 30th and 
50th degree of latitude; and while the sun is south of the equator, 
that from the 20th to the 35th or 40th degree of north latitude 
will be found the most salutary. During winter, voyages be- 
tween Madeira and the West Indies, and in summer between 
Madeira and this country, in the vessels constantly trading be- 
tween England and the West Indies, and which generally touch 
at Madeira, might be undertaken with advantage. These vessels 
furnish tolerable accommodations, which may be easily improved 
or adapted to the state of the invalid. 

"When the winter has been passed in any of the warmer 
situations noticed above, attention ought to be paid to the time of 
returning to this country. This should not be earlier than the 
first, or later than the last week in June. If the invalid have 
passed the winter in the south of France or in Italy, these places 
may be left early in May, and he may travel cautiously through 
Switzerland, avoiding exposure to the evening and morning air. 
During the journey warm clothing should be resorted to as soon 
as the temperature falls so low as to feel sensibly cold ; and a free 
circulation in the skin and extremities ought to be carefully pre- 
served." 

It has been well said that we have almost every shade and 
variety of climate in our own country to gratify the most fastidi- 
ous in their selection of places where they may hope to regain 
lost vigor and to prolong existence. Some, in that surely fatal 
disease, phthisis pulmonalis, have hoped to find the summit of 
their anticipations in the sunny South, while others have sought 
the desideratum in the far North. My own opinion is, that 
nine-tenths of all who travel far from home and friends on such 
errands would realize more true comfort, physical, moral, and 
mental, at their own domiciles, unless they make the experiment 
very early in the attack. Late in the seizure is too late for per- 
manently good results. 

Clystees. Enemata. Injections. — A very good paper on 
the uses of clysters may be seen in No. xiii. of Braithwaite s 
Retrospect, beginning at page 97. The value of this mode of 
medication we fear is not sufficiently appreciated by the profes- 
sion, and hence the infrequency of mention made of them in 
medical reports. 

A clyster or injection is intended, for the most part, to evacu- 



342 VARIOUS KINDS OF CLYSTER. 

ate and clean out the lower portion of the alimentary canal. 
Sometimes an injection is given simply to clean away fecal and 
mucus collections from the gut, and to make the mucous sur- 
face more susceptible of the action of more energetic injections. 
Thus, warm water is often made to precede a medicated clyster, 
which acts more efficiently than if given without this simple pre- 
paration. 

Owing to similarity of structure it was found long ago that 
remedial agents operated on the system through the medium 
of injections in the same manner as when administered by the 
mouth, and that nutriment could be exhibited in the same way. 
When the stomach is exceedingly irritable, and would reject 
medicine or food, we can get all the advantages of either by 
means of a clyster. As a general rule, the dose by injection 
should be three times larger than that by the mouth. Thus, 
sixty drops of laudanum by clyster are equal to twenty drops 
taken in the ordinary 'way. 

That the surface of the intestines is absorbent may be proved 
by the disappearance of enemata thrown into them. Liebig 
states that a solution of common salt, in the proportion of one 
part to eighty of water, disappeared so completely from the 
rectum that an evacuation an hour afterward was found to 
contain no more than the usual proportion of salt. — Animal 
Chemistry, p. 77. 

In cases of habitual costiveness, dependent on torpor of the 
alimentary canal, it is often best to reject all internal medicines, 
and to rely on injections of cold or warm water, repeated morn- 
ing and night, or oftener. A pint is the proper quantity for an 
adult. If there be a plethoric condition, cold water is gene- 
rally most suitable ; if the patient be feeble, warm water will 
answer better. This expedient invariably cleans out the bowel, 
and generally excites more natural action higher up. It is a safe 
method, and too seldom resorted to. 

Various gaseous matters have been employed by way of in- 
jection, and among them tobacco smoke is perhaps the most 
energetic. There is less risk in employing the smoke than the 
infusion or decoction of tobacco. The quantity to be adminis- 
tered can be better regulated, and the dangers attendant on the 
decoction are obviated to a considerable extent. Great care, 
however, is required in its exhibition, because of its powerfully 
depressing or sedative quality. The relaxation induced by in- 
jections of the smoke or decoction is often highly important in 
obstructions of the canal and for the reduction of obstinate dislo- 
cations. 

The books speak of the simple, the laxative, the purgative, 
the emollient, the anodyne, the tonic, the astringent clyster, to 



USES OF CLYSTERS. 343 

which we may add the antiperiodic. One of the simplest clys- 
ters that can be used is strong and warm soapsuds, thrown up 
in the quantity of a half-pint and repeated. Or we may add 
two tablespoonfuls of soft-soap to a pint of soft water, milk 
warm, or to a pint of buttermilk, or broth, or barley-water, or 
thin gruel. Either will soften and remove compact fecal matter 
and clean off the mucous coat. 

A gently laxative clyster is made of equal parts of common 
salt, molasses, and sweet oil, (a tablespoonful,) diffused in a half- 
pint of warm water. It will be a little more active if we add 
an ounce of Epsom salts, or the same quantity of castor oil, or 
both, to a pint of buttermilk or thin starch or gruel. 

The purgative clyster is still more efficient. An ounce of 
Epsom salts and a half-pint of the infusion of senna will make an 
injection of considerable activity. Or we may add two drachms 
of powdered aloes and a half-ounce of soft soap, well rubbed 
together, to a pint of water, boiling the whole for the space of 
ten minutes. A still more energetic clyster is made by com- 
bining two ounces of castor oil and two teaspoonfuls of the spirit 
of turpentine with a half-pint of gruel or thin starch. Either 
of the above will be found very serviceable in cases of obstinate 
constipation, and, if need be, they can be safely repeated several 
times in the course of a few hours. 

The emollient clyster is called for in dysentery and in other 
diseases attended with much irritability of the lower bowels. It 
may be variously compounded. One of the simplest consists of 
flaxseed tea, from a half-pint to a pint. Flaxseed oil alone, or 
added to gruel, will also answer very well. From two to four 
ounces of fresh butter, or the same quantity of sweet oil, in a 
half-pint of thin starch or slippery elm infusion, will make a 
good emollient clyster. An ounce of mutton suet well grated 
and boiled in a pint of milk will give an excellent injection, and 
one that has been very useful in dysenteric affections. 

The anodyne clyster is made of opium or laudanum, or any 
of the salts of morphia, or of the various narcotic vegetable ex- 
tracts, dissolved in water or thin starch. The laudanum injec- 
tion is often employed to restrain irritability of the rectum, and 
then, of course, the quantity should be small, even for an adult. 
Two or three ounces of gum-water or thin starch, with sixty 
drops of laudanum, will generally suffice. 

The tonic clyster is generally composed chiefly of Peruvian 
bark. It was very often administered prior to the use of the 
sulphate of quinine, because the stomach frequently rejected the 
bark. For an adult, an injection of a half-pint should contain 
six drachms of the bark, which may be mixed with thin gruel, 
and administered at once, or in two parts. The daily use of this 



344 FORMULiE FOE CLYSTERS. 

injection will sometimes set up costiveness, to prevent which a 
half teaspoonful of Epsom salts should be added. If, on the 
contrary, purging should follow the injection, that should be re- 
strained by the addition of an eighth or a quarter of a grain of 
the acetate of morphia, or from ten to twenty-five drops of 
laudanum. 

The astringent clyster may be made of any of the well-known 
astringents, as tannin, or galls, or oak bark, or rhatany, or sugar 
of lead, or alum, or strong vinegar. 

In the treatment of low fall fevers, which are often called 
tyi^hoid, though essentially remittents, the physician is some- 
times harassed with frequent bloody evacuations that greatly 
enfeeble and alarm the patient. Superadded to these there is 
often a wasting and offensive diarrhoea. In such cases I have 
employed with obvious benefit the following antiperiodic and 
astringent injection : — Sulphate of quinine, from twenty to sixty 
grains, dissolved in from two to four ounces of the sharpest vine- 
gar, and thrown up every two or three hours. Under this treat- 
ment I have witnessed not only the cessation of the hemorrhage 
and looseness, but also the cleaning of the tongue, the arrest of 
tremors and subsultus tendinum, the elevation of the pulse, and 
the subsidence of all febrile symptoms. 

In reference to the quantity of an injection to be used at one 
time it is not necessary to say much, as that must depend very 
much on circumstances. Ordinarily, from two to four ounces 
will suffice for children from one to eight years of age, and from 
a half-pint to a pint for adults. 

We subjoin a few useful formulae for the preparation of in- 
jections: — 

Clyster of Aloes and Assafcetida. 3. R. — Assafoetid. gij; 

-r, ., _ Spt. ammon. aromat. 5iss; 

Assatoetm. ^iss,^ Decoct, amyli, zviij. 

Camphor, grs. xij ; Mix J ° J 
01. olivar. ^iss; 

Decoct, aven. ^xij. 4. R. — Assafoetid. gi; 

Mix. [For flatulent colic, ascarides, Camphor, grs. x. 

&c] Rub with decoct, amyli, spraj, and 

add spt. terebinth, gss. Mix. 



Compound Clyster of Colocynth. 



Antispasmodic Clysters. 

1. R. — Tinct. opii, 

Pulv. valerian, aa gi ; 

Muc. g. Arab. gij. R.— Colocynth pulp, gi; 

™ 1X> Aquae, ^xij. 

2. R. — Tinct. opii, gi; Boil a few minutes, and strain; then 

Pulv. ipecac, gss; add 

Decoct, hord. ^vi; Magnes. sulph. ^ss; 

Camphor, grs. iij. Syr. rhamni cath. ^ss. 

Mix. Mix. 



COCOS NUCIFERA — COCCULUS INDICUS. 



345 



Emollient Clyster. 

R. — Flor. cliamoemil, 
Sem. lini, a a ^ss; 
Aquae ferv. ^vi. 
Macerate and strain, then add 

Pulv. opii, gr. i. 
Mix. 

Sedative Clyster. 
R. — Sem. lini contus. ^i; 

Aquas ferv. ^viij. 
Macerate for one hour, strain, and 
add 

Sodae, bibor. ^j ; 
Pulv. opii, grs. iij. 
Mix. 

Turpentine Clysters. 

1. R. — Camphor. T)i; 

Spt. terebinth, Hji; 
01. olivar. ^ij; 
Decoct, avenas, ^viij. 
Mix. 

2. R.— Spt. terebinth, -fi; 

Yitell. ovi, i; 
Rub well together, and add 

Decoct, avenas, ^x; 

01. ricini, ^i. 
Mix. ]£.. 

3. R.— Spt. terebinth, gi; 

01. olivar. ^iss; 
Camphor, grs. xv; 

Decoct, avenas, ^viij. Mix. 

Mix. 



Anthelmintic Clyster. 

R. — Bad. valerian, 
Absinthii, 
Tanaceti, 

Sem. santon. aa ^iij ; 
Aq. bullient. ^xij. 
Digest for two hours, and strain. 
Then add 

Sodas mur. ^ss. 
Mix. 

Antiperiodic and Astringent Clyster. 

R. — Quin. di-sulph. ^ss; 
Aceti fort, ^iv; 
Argent, nit. grs. ij; 
Morph. sulph. gr. i. 
Mix. 

Tonic Clyster. 

R. — Pulv. cinchon. opt. ^ss; 
' ' gentian, 
" Calumbo, aa spj; 
Aquas bullient. Qj. 
Digest for two hours, and strain. 



Mild Cathartic Clyster, 

-Mur. sodas, 
Molasses, 
01. olivar. aa gj ; 
Decoct, hordei, jfviij. 



Cocos Nucifera. Cocoanut Palm. — The well-known oil of 
the cocoanut, so indispensable to the existence and comfort of 
the Fejee islanders, as they think, has been employed as a substi- 
tute for cod-liver oil for several reasons : — 

1. Because it is cheaper and more palatable and never 
nauseates. 

2. Because successful after cod-liver oil had failed. 

Dr. Thompson thinks he has arrested the march of phthisis by 
the use of this substitute. — JBraithwaite, p. xxix. p. 92. 

Cocculus Indicus. — This is the fruit of the menispernum 
cocculus, a creeping plant growing in Ceylon and other parts of 
the East Indies. The berry is like a large, rough, black pea; 
and is commonly called cocculus indicus and fish berry, or fish 
poison, under which names it is sold in all our drug stores. I 
have often, when a lad, made it into pills with crumbs of bread, 
and caused small fish to be "drunk with it," as we used to say. 
The berries are ground or coarsely pulverized for this purpose. 
The fish dart at it with eagerness, and in a few minutes the sur- 
face of the water is covered with the fish, some dashing about, 

23 



346 COCCULUS INDICUS. 

others apparently insensible. I never knew any injury to result 
from eating fish caught in this way. 

One of the most objectionable uses of the berry is as a substi- 
tute for hops in the formation of beer ; and knowing its poison- 
ous quality, the adulteration is prohibited in England by severe 
statutes. It is said that the brewers resort to it expressly to 
increase the intoxicating power of beer, ale, and porter; and 
no doubt this is so. When Mr. Delevan publicly charged the 
brewers in Albany with making use of the dirty water from the 
gutters in the manufacture of beer, they made a terrible uproar 
and threatened a prosecution. But knowing that this was not 
the worst allegation that could be substantiated, they very 
prudently suffered a non-suit, and paid the costs. They employ 
cocculus indicus after the manner of their teachers across the 
water, because there is here no statute to prohibit the nefarious 
act. Now that it may be seen that this berry is truly a poison, 
we have to say that M. Boullay, of Paris, has separated its 
alkaloid principle, called by him and now known in the books 
as picrotoxine, or the bitter poison, as the word literally means. 
This constitutes one-fifth part of the kernel, and ten grains of 
it killed a dog in twenty-five minutes in a second paroxysm of 
tetanus. 

Mr. Accum, speaking of this adulteration of malt liquors, 
justly observes, "The effects may be gradual, and a strong con- 
stitution and hard labor may counteract somewhat, and for a 
time, the destructive consequences, but the baneful effects will at 
length appear. It is, moreover, a well-established fact that 
habitual drinkers of malt liquors are more liable to apoplexy 
and palsy than other persons." 

Even so long ago as the time of Queen Anne the deleterious 
nature of cocculus indicus was known, and an act was then passed 
to prohibit brewers from employing it. Since then, not only the 
berry, but an extract, called by the names black extract and hard 
multum, has been prepared as a regular branch of business, and 
vended to the brewers. 

The only case of poisoning I have ever witnessed by means of 
the cocculus indicus is recorded in the first volume of the Western 
Medical Gazette, and quoted in Beck's Medical Jurisprudence. 
A nurse who had a strong propensity to get drunk when she had 
a chance, and from whom all kinds of drink were concealed, 
found after some trouble a large bottle containing a fluid pre- 
pared for killing vermin. It was whisky or rum, with a large 
quantity of cocculus indicus in powder, and of course a tincture 
of the berries was present. The smell was too well understood 
to let the opportunity pass. She drank freely of it again and 
again, and when I saw her was evidently poisoned. She had 



COCHLEARIA ARMORACIA. 347 

been drunk too often in the usual way to admit of a doubt that 
her present condition depended on something more than alcohol. 
She was comatose, pulseless, foaming at the mouth, convulsed, 
and her jaws locked. As an emetic could not be passed into the 
mouth, tobacco leaves soaked in hot water were laid on the epi- 
gastrium, which soon induced vomiting and purging, and the 
patient was out of danger. 

Of nine persons sickened by soup that contained some of the 
powdered berries added in mistake for pepper, one died in twelve 
days; vomiting, pain in the stomach and bowels, attacked all of 
them. We have no account of the morbid appearances. But 
the poison is fitly placed among the narcotico-aerids. 

The Arabian physicians formerly employed this article in 
practice, internally as well as externally. The only use of it 
now is for diseases of the skin, although it is probable that a due 
investigation would show that the internal exhibition might be 
salutary. 

Drs. Hamilton and Christison speak well of an ointment for 
the management of ringworm and tinea capitis. It is made by 
triturating a drachm of the powdered kernels with an ounce of 
lard and rubbing it into the surface night and morning. Care 
should be taken to clean the parts well with warm soapsuds. 
The irritation of the skin is speedily allayed, and in three or four 
weeks the disease has yielded. A similar ointment has been suc- 
cessfully employed in the management of the common itch, aided 
by suitable correctives of the digestive organs. 

Cochlearia Armoracia. Horseradish. — To show how little 
the drawings of plants in books of Materia Medica are worth to 
young students, or to any persons whatever, I cite the fact that 
the full-grown horseradish is now in my garden as perfect as it 
can be, and between it and the drawing now before me in a popu- 
lar work (held by many to be among the best standard books) 
issued by an extensive publishing house in this city, there is no 
sort of resemblance that I can detect. Well and truly colored 
drawings may be useful, but naked figures such as that referred 
to are a waste of ink and paper. 

The horseradish is too well known to call for a picture of any 
sort. Everybody is familiar with it, and its table use is almost 
universal. The activity of the article and all its good qualities 
are most obvious when the root or leaf is fresh and juicy. Dry- 
ing almost entirely destroys the value of the plant. The green 
leaf as taken from the garden and soaked in hot vinegar or 
water will act as a rubefacient, and sometimes even vesicate. 
The well-bruised root will do the same. The energy is depend- 
ent on a volatile oil, which soon vanishes after the root or leaf 
is laid aside to dry. 



348 COD-LIVER OIL. 

Internally horseradish is stimulant and diuretic. The com- 
pound spirit of horseradish contains the activity of the plant, 
and is a good adjunct to diuretic infusions, especially in the aged 
or very feeble. It is made by macerating, for twenty-four hours, 
sliced horseradish root and orange peel, of each twenty ounces ; 
bruised nutmegs, five drachms; proof spirit, a gallon; water, 
two pints. Distil, from the whole, one gallon, which is the com- 
pound spirit. It is not only a good internal medicine, but is 
found to be an excellent rubefacient. 

Cod-Liver Oil. — Oleum Jecoris Aselli. — This article, which 
has been in use in various parts of Europe for many years, is 
now extensively employed in this country. In fact, such has 
been its popularity that it is employed by not a few persons in 
almost every form of disease, but more especially in affections of 
the chest, rheumatism, &c. &c. It is so well known to all classes 
of individuals that it is not necessary to give a minute descrip- 
tion. It has been procured from the livers of other fish besides 
the cod, and some have supposed the skate-tiyer oil to be more 
decidedly remedial than any other kind, because it contains more 
iodide of potassium. This statement is made in the Edinburgh 
Medical and Surgical Journal for October, 1842, and is fully 
borne out by an article in Medical Commentaries, vol. iii., which 
informs us that the skate-liyer oil was employed in the Highlands 
of Scotland nearly a hundred years ago for the cure of rickets. 
The oil was rubbed into the skin daily, and a flannel shirt pre- 
viously dipped in the oil was constantly worn. 

In Erasers Magazine for November, 1850, there is an in- 
teresting article entitled "Leaves from the Note-book of a 
Naturalist," in which a passage is cited from Pliny to show the 
antiquity of the use of animal oil in scrofula. Speaking of 
turtles, he says, " If their flesh be eaten, together with the broth 
in which they are sodden, it is held very good to discuss the 
king's evil and to dissipate or resolve the hardness of the swelled 
spleen." 

Bog-liver oil has been successfully employed in mistake for 
cod oil, and a very ludicrous anecdote has been given to the 
newspapers on this blunder. So sturgeon oil has got into the 
market by some who thought they could make a penny by palm- 
ing it off for the genuine article. 

Grlycerine has been named as a substitute for cod-liver oil by 
Dr. Crawcour, of New Orleans. He says it is quite as efficacious, 
far less disagreeable, does not disorder digestion, and may be 
combined with any other remedy. Besides its antistrumous 
power, it very much aids in assimilating the salts of iron, espe- 
cially the iodide. Quinine dissolves in it, unaided by sulphuric 
acid, and is divested of part of its bitter taste. From one to 



COMPARATIVE ANALYSIS. 



349 



three drachms per day are given in a little water. To be suc- 
cessful it should be pure. — Gazette Medicale, 1855. 

I have known some very remarkable cases of obvious improve- 
ment on the use of this oil by persons laboring under pulmonary 
phthisis. It has also been very serviceable in chronic bronchitis, 
rheumatic neuralgia, scrofula, gout, &c. &c. 

The best oil, in my judgment, is the light brown, to be had of 
tanners and curriers. This, it will be seen, has in its composi- 
tion rather more of iodine, bromine, and chlorine, than the light 
yellow or the dark brown. 

Mr. John C. Baker, a respectable druggist of Philadelphia, 
has published in the Medical Examiner the following interest- 
ing analysis of cod-liver oil. It will be seen that the light 
brown variety, which is now preferred, contains the most iodine, 
bromine, and chlorine, as already intimated. 



Comparative Analysis of the three different kinds of Cod- 
Liver Oil. 

Brown. Light Brown. Light. 

Oleic acid (with Godwin) . . . 69.78500 71.75700 74.03300 

Margaric acid 16.44500 15.42100 11.75700 

Glycerine 9.71100 9.07300 10.17700 

Butter acid 0.15875 0.07436 

Acetic acid 0.12506 0.04571 

Fellic or cholic acid, with traces of mar- 

gerin, alein, and bilifulvin . . 0.29900 0.06200 0.04300 
Bilifulvin, billifellic acid, and two other 

peculiar substances . . . 0.87600 0.44500 0.26800 
A peculiar substance soluble in alcohol 

of 30° 0.03800 Q.01300 0.00600 

A peculiar substance insoluble in water, 

alcohol, and ether .... 0.00500 0.00200 0.00100 

Iodine 0.02950 0.04060 0.03740 

Chlorine and traces of bromine . . 0.08400 0.15880 0.14880 

Phosphoric acid 0.05365 0.07890 0.09133 

Sulphuric acid 0.01010 0.08595 0.07100 

Phosphorus 0.00754 0.01136 0.02125 

Lime 0.08170 0.16780 0.15150 

Magnesia 0.00380 0.01230 0.00886 

Soda 0.01790 0.06810 0.05540 

Iron ....... Traces. 

Loss 2.56900 2.60319 3.00943 

100.00000 100.00000 100.00000 

Donovan, in the London Lancet for February, 1846, tells us 
that the livers of the codfish are best for yielding oil in January ; 
that 1000 will then weigh 900 lbs., whereas the same number 
and of the same size will only weigh 575 in March. The former 
will yield about thirty-seven gallons of oil, which, if pressed im- 
mediately, is pale, and darker colored in proportion as the pres- 
sure is deferred. 



350 USES OF COD-LIVER OIL. 

To some persons the taste of cod-liver oil is 'exceedingly dis- 
gusting, and hence the expedients resorted to for the purpose of 
avoiding this objection. It has been stated that the chewing of 
orange peel before and after swallowing the dose will suffice. 
But the best mode by far is to mix the oil with a tablespoonful 
or more of good ale, or to swallow the ale immediately after the 
oil. It is possible that some persons take the oil for the sake of 
the ale, which they consume in larger portions than I have 
named. 

The addition of ten per cent, of common house salt to the 
usual dose of oil, we are assured, will make it much more palat- 
able, and fit it the better to be promptly digested. 

Dr. B. Rush Mitchell, U. S. N., says that the best vehicle for 
the oil, for patients with harassing coughs, is the syrup of wild 
cherry bark. He has employed it with decided advantage in 
consumptive patients. 

The close for an adult should be a tablespoonful three times a 
day, which may be gradually increased to a half-pint. 

The most satisfactory account yet published on the use of cod- 
liver oil in pulmonary consumption has been furnished by Pro- 
fessor Williams, of University College, London. The article is 
as follows : — 

" There is no department of medical knowledge which seems 
to me to stand so much in need of improvement as that which 
relates to the operation of medicines. Even with regard to those 
most commonly used, it is surprising what a diversity of opinion 
prevails among different practitioners ; and, as a necessary con- 
sequence, there is an almost equal variation in the modes and 
combinations in which each medicine is administered. Yet it is 
pretty obvious that, as truth is essentially simple and constant, 
there must be much of error in such diversity of opinion and 
practice, and the sooner the truth is elicited by a careful and 
rational examination of facts bearing upon each subject the more 
safe and satisfactory will our practice become. 

" The remedial influence of the cod-liver oil particularly de- 
serves this kind of investigation ; not only because its mode of 
operation is a subject of much difference of opinion, but because 
the effects ascribed to it by many practitioners are of a very pal- 
pable and positive kind ; and because such effects have not hitherto 
been obtained from any other remedial agent. The object of 
the present communication is to record the chief results of my 
own experience in the use of this remedy in tuberculous and 
analogous diseases of the lungs. These results will be arranged 
briefly under the following heads : — 

" 1. General results of the use of cod-liver oil in phthisis pul- 
monalis. 



EFFECTS OF COD-LIVER OIL. 351 

"2. On its mode of operation. 

" 3. On its preparation and administration. 

" 1. General Results of the Use of Cod-Liver Oil in Pulmo- 
nary Consumption. — I have prescribed the oil in above four 
hundred cases of tuberculous disease of the lungs in different 
stages, which have been under my care in private practice during 
the last two years and a half. Of these I have two hundred 
and thirty-four cases recorded in my note-books, with the re- 
sults of the treatment at various intervals ; these constitute the 
chief materials of the present communication. 

" Out of this number, the oil disagreed, and was discontinued, 
in only nine instances. In nineteen, although taken, it appeared 
to do no good ; while in the large proportion of two hundred and 
six out of two hundred and thirty-four its use was followed by 
marked and unequivocal improvement ; this improvement varying 
in degree in different cases, from a temporary retardation of the 
progress of the disease, and a mitigation of distressing symp- 
toms, up to a more or less complete restoration to apparent 
health. 

" The most numerous examples of decided and lasting improve- 
ment, amounting to nearly one hundred, have occurred in patients 
in what is usually termed the second stage of the disease, in 
which the tuberculous deposits began to undergo the process of 
softening, the common physical signs being defective movement 
and breath-sound, with muco-crepitation and marked dullness 
below or above a clavicle, or above a scapula, and tubular breath 
and voice-sounds toward the root or inner part of the apex of 
the same lung. Such patients generally have had cough for some 
months, latterly with muco-purulent or opake yellowish or 
greenish expectoration, and have begun to lose flesh, color, and 
breath in such a degree as to excite alarm and induce them to 
seek further advice. With many, night-sweats had occasionally 
occurred, and hemoptysis may have been present at a former 
period. 

" The effect of the cod-liver oil in most of these cases was 
very remarkable. Even in a few days the cough was mitigated, 
the expectoration diminished in quantity and opacity ; the night- 
sweats ceased ; the pulse became slower and of better volume ; 
and the appetite, flesh, and strength were gradually improved. 
The first change manifest in the physical signs was generally a 
diminution and gradual cessation of the crepitus ; the breath- 
sound becoming drier and clearer ; but the dullness and tubular 
character of the breath and voice-sounds were much more per- 
sistent, and rarely exhibited a marked decrease until after several 
weeks' use of this remedy in conjunction with regular counter- 
irritation. The tubular sounds in fact frequently become louder 



352 USES IN PHTHISIS. 

at the first removal of the crepitus, which in phthisis as well as 
in pneumonia tends to mask the signs of consolidation. In 
several instances, however, in which I have had the opportunity 
of examining the patients under treatment at several successive 
intervals of a month or six weeks, the gradual removal of the 
consolidations has been unequivocally proved by the restoration of 
clearer vesicular breath and stroke-sounds to the affected spots. 
In several cases in which the disease has existed long, the resto- 
ration has never been perfect; even where the health has been 
completely re-established, and all common symptoms of disease 
have entirely disappeared, there have remained perceptible in- 
equalities in the breath and stroke-sounds ; generally with pro- 
longed expiratory sound, which has more or less of a tubular 
note toward the root of the lung of the same side. These 
signs, if unaccompanied by decided dullness on percussion, I 
have learned by the experience of many years not to consider as 
exceptional against recovery, for they appear to be dependent on 
the puckering of the texture, often with pleural adhesions and 
old deposits in the bronchial glands, so frequently found after 
death at the summits and near the roots of the lungs of persons 
who have not for many years exhibited symptoms of any pec- 
toral disease. 

" As might be anticipated, a large number of the phthisical 
patients for whom I have been consulted have been in the first 
stage of the disease, in which the tubercles or deposits are in 
the solid state. In these cases, also, I have largely used the 
cod-liver oil, and, so far as I have ascertained them, with not 
less satisfactory results ; but a large proportion of these patients 
I have been unable to add to the numbers mentioned above from 
my having seen them only once, or not frequently enough to 
enable me to determine with accuracy the results of the treat- 
ment. Such patients do not commonly consider themselves 
sufficiently ill to be under constant medical treatment ; and 
although the good effect of the oil is commonly manifest in the 
abatement of cough and feverish excitement, and in the im- 
provement of flesh and strength, yet the benefit is less speedy 
and obvious than in the more advanced stages of the malady. 
The physical signs of improvement are precisely the same as 
those which take place tardily in the second stage after the 
removal of the humid rhonchi ; and, in truth, the treatment by 
the oil, combined with counter-irritation, where successful, seems 
to bring back the lungs from the second stage, that of incipient 
softening, to the first stage, that of simple deposit, which is 
tardier in its changes of increase or diminution, and may remain 
long stationary without any obvious alteration. The same re- 
mark is applicable to the chronic products of inflammation of 



MODUS OPERANDI OF THE OIL. 353 

the lung, which, as is known to the profession, I consider to 
approximate in nature to the higher class of tuberculous de- 
posits. 

" The most striking instance of the beneficial operation of cod- 
liver oil in phthisis is to be found in cases in the third stage, 
even those far advanced, where consumption has not only exca- 
vated the lungs, but is rapidly wasting the whole body with 
copious purulent expectoration, hectic, night-sweats, colliquative 
diarrhoea, and other elements of that destructive process by which 
in a few weeks the finest and fairest of the human family may be 
sunk to the grave. 

" The whole number of cases in the third stage of phthisis 
(that is, with one or more cavities, as indicated by physical 
signs) which have been manifestly improved under treatment with 
the cod-liver oil amounted to sixty-two up to the end of August. 
In thirty-four of these I know that the improvement has con- 
tinued up to a recent period, when I saw the patients, or had 
reports. Eleven cases which exhibited decided improvement 
for a time have since again declined or terminated in death. 
Of the remaining seventeen I have had no recent report, and 
I do not know whether the amelioration has been permanent or not. 

" The results above stated give to cod-liver oil, even as a tar- 
dative or palliative in phthisis, a rank far above any agent 
hitherto recommended, whether medicinal or regiminal. I have 
made extensive trials of several other medicines of reputed utility 
in this disease, and on a future occasion may lay before the pro- 
fession the results of my experience, which prove some of these 
agents to be by no means inoperative or useless ; and I still 
consider them to be often salutary aids in the treatment of this 
formidable malady ; but their utility and harmlessness fall so far 
short of those of the cod-liver oil, that I regard them now chiefly 
as subsidiary means, and the more likely to be useful in propor- 
tion as they facilitate the exhibition or continuance of this superior 
agent. 

" If the experience of the profession at large should accord 
with my own, and with that of those who have preceded me in 
recommending the cod-liver oil, our prognosis with regard to 
phthisis must undergo some modification. To what extent this 
modification may reach cannot be determined until such cases as 
those which I have recorded have been tested by years of time ; 
but even now, when we repeatedly find forms and degrees of dis- 
ease that former experience had taught us to be utterly hopeless 
and speedily fatal, retarded, arrested, nay sometimes even re- 
moved and almost obliterated by various processes of restored 
health, we must pause ere we in future pass the terrible sentence 
of ' no hope' on the consumptive invalid. 



354 MODUS OPERANDI OF THE OIL. 

" 2. Mode of operation of Cod-Liver Oil. — It seems scarcely 
necessary to discuss the question whether the oil owes its efficacy 
to the iodine which it contains. The amount of this element is 
so minute as hardly to admit of quantitative measurement ; and 
to ascribe virtue to such infinitesimal fractions, when ordinary 
doses have no corresponding activity, is to adopt the fanciful and 
mischievous speculation of the homoeopathist, which cannot be 
too strongly deprecated by the scientific and conscientious prac- 
titioner. Several of the patients whose cases are cited above, 
and many more of whom I have records, had taken iodine in va- 
rious combinations before taking the oil, but without any effects 
approaching to those which ensued on the change of treatment. 
I am by no means incredulous of the salutary operation of 
iodine in some forms of tuberculous and scrofulous disease; in- 
deed, until I used the pure oil, I considered it to be the most 
useful remedy ; but in the last two years the oil has so far sur- 
passed it and every other me(Mcine in beneficial operation that I 
am convinced that it acts by a virtue peculiar to itself. 

" The cod-liver oil is a highly nutrient material; and it is com- 
monly admitted by all practitioners who have used it that it pos- 
sesses in a pre-eminent degree the property of fattening those 
who take it for any length of time. But its nourishing influence 
extends beyond the mere deposition of fat in the adipose tissue. 
The muscular strength and activity are sensibly and sometimes 
rapidly increased under its use ; while the improved color of the 
cheeks and lips implies a filling of the vessels with more and bet- 
ter blood. Researches are wanted to elucidate this subject more 
clearly; but the analysis of the blood in one case of phthisis, 
which had been under treatment by the oil, showed a most 
remarkable increase of the animal principles of the blood, 
especially the albumen, which amounted to thirteen per cent., 
being nearly double its usual amount, while the fat was not ma- 
terially augmented ; and the fibrin, which is generally high in 
phthisis, was reduced below the normal proportion. If these re- 
sults should be confirmed by further observation, there will be no 
difficulty in understanding that the cod-liver oil should prove a 
nutrient to all the textures ; although it may yet be a question 
whether it does so by direct conversion into albumen or fibrin, 
or by preventing the waste of the albuminous principle by pro- 
tecting it from the action of the oxygen absorbed in respiration.* 

* Much testimony could be adduced to prove the powers of the oil in 
augmenting the weight of the consumptive patients. This result I have wit- 
nessed most decidedly. It is also averred that its continued use has often pre- 
vented the development of phthisis in persons supposed to have an hereditary 
taint. In the Louisville Marine Hospital I witnessed its power to control the 
fetor of the breath of consumptive patients to a most remarkable extent. 



CHEMICAL ACTION OF THE OIL. 355 

" But there is much reason to believe that the oil itself proves 
serviceable in supplying the fat molecules which appear to be es- 
sential to healthy nutrition, as forming the nucleoli of the 
primary cells or rudiments of tissues. The important part which 
fat thus performs in the process of nutrition was first pointed 
out by Ascherson of Berlin ; and that fat forms the central mole- 
cules of the elementary granules and cytoblasts of textures 
is generally admitted, although few agree with Ascherson in his 
opinion that the fat forms the cells by its power of coagulating 
albumen around it. It seems to have been the opinion of Dr. 
Ascherson and of Dr. Hughes Bennett, who cites it, that in 
scrofulous diseases there is a want of this fat, and that the albu- 
men derived from the food in digestion is liable to be precipitated 
in an unorganizable condition (as tubercle, etc.) for the lack of 
it. But it is now well ascertained that scrofulous and tubercu- 
lous deposits, so far from being deficient in fatty particles, con- 
tain them in greater quantity than exists in the blood, or in its 
plasma in a healthy state. The explanation which I have given 
of the chief salutary action of the cod-liver oil is not that it sup- 
plies fat where it is wanting, but that it supplies fat of a better 
kind, more fluid, more divisible, less prone to change, and more 
capable of being absorbed into and of pervading the structures 
of the body, thus affording a fine "molecular base" in the 
chyle, and therein a material for a better plasma ; and being con- 
veyed into the blood, distributed through capillaries and around 
deposits, (in such quantity as to soften and dissolve the crystal- 
line and irregularly concreted fat scattered through them,) it 
renders them more amenable to the processes of reparation and 
absorption. Hence its beneficial operation is more marked in 
those stages of tuberculous disease in which the deposits abound 
in fat — that is, at the period of maturation of softening ; al- 
though from the extent of mischief already done, both to the 
part and to the system, the benefit may not be so lasting as in 
the early stages of the disease. 

" One of the most remarkable effects of the cod-liver oil, in 
some cases of the second and third stages of phthisis, and in 
other forms of scrofulous disease with extensive suppuration, is 
the speedy removal of the sweats and other symptoms of hectic 
fever. This can hardly be ascribed to its direct nutrient powers, 
but I think that it is due to its influence in diminishing the un- 
healthy suppuration which is excited around the softening and 
excavated tubercles. If my views of the chemical nature of 
suppuration — that it consists of a further oxidation of the exuda- 
tion corpuscle — be correct, then it is quite intelligible that the 
presence of so highly combustible a material as oil must check 
this process of oxidation and thus prevent the degeneration of 



356 ACTION OF COD-LIVER OIL. 

the corpuscles into the aplastic state of pus globules. In fact, if 
it should prove to be correct, according to the analysis above 
quoted from Simon, that cod-liver oil removes the excess of fibrin 
in the blood of phthisical patients, this also equally accords with 
my notion, founded on the inferences of Mulder and others, that 
the formation of fibrin is due to a process of oxidation of the 
albumen, (forming a deutoxide of protein, according to Mulder,) 
and that by preventing this the oil removes that tendency to ca- 
coplastic inflammatory deposits, which largely contribute to in- 
crease the consolidation of the lungs and other organs in phthisical 
subjects. 

" In making these surmises I would not be supposed to adopt 
the idea of Liebig, that pulmonary consumption is the result of 
an excess of oxygen in the blood at large, consuming its mate- 
rials and those of the textures. Many of the symptoms, as well 
as the organic lesions of the disease, show that there is a great 
deficiency in the process of respiration by which oxygen is sup- 
plied to the blood, and some of the most rapidly fatal cases, ex- 
hibiting speedy emaciation, are, throughout their course, in a 
condition bordering on asphyxia. Here is obviously a great 
want of oxygen in the blood ; nay, I believe the excess of fat in 
the liver and in the tuberculous deposits, in these instances, to 
be caused by this very scanty supply of oxygen to the system. 
But, although it is deficient in the system, enough oxygen comes 
into contact with the exudations from cavities in the lungs, and 
from the diseased bronchi in their vicinity, to effect the for- 
mation of much unhealthy pus ; and it is the formation and re- 
absorption of this that seems -to excite the hectic of phthisis, as 
well as to keep up much harassing local irritation. Now, I be- 
lieve it to be by diminishing these exudations, and checking their 
further oxidation into pus, that cod-liver oil acts so promptly in 
reducing the hectic sweats and purulent expectoration of 
phthisis, which accelerate and aggravate its destructive pro- 
gress. 

" The limits of this paper will allow me to notice but briefly 
one more point in regard to the action of cod-liver oil. Unlike 
other oils or fats, it rarely disorders the stomach or bowels or 
disturbs the functions of the liver. If taken in any quantity, 
vegetable oils commonly purge, animal oils turn rancid in the 
stomach, causing heartburn, bilious attacks, and even jaundice. 
On the contrary, cod-liver oil generally improves all the 
chylopoietic functions, and distinctly promotes the action of the 
liver ; so that the appetite and power of digestion are restored 
and patients are enabled to take an amount and variety of food 
beyond what they are accustomed to even in health. I cannot 
help thinking that this peptic influence of the oil is due to its 



EXHIBITION OF THE OIL. 357 

containing some biliary principle, which both favors its divisi- 
bility in the process of digestion and promotes the natural secre- 
tions of the liver. The flow of bile, as indicated by the color 
of the faeces, is generally free and uniform during its ex- 
hibition ; and I must not omit to notice another fact, which I 
believe to be connected with increased activity of the liver. I 
have in numerous instances remarked that the bulk of the liver 
(as determined by percussion) becomes augmented during its use ; 
yet without tenderness or any other sign of disorder. In fact, 
this seems to be a kind of useful hypertrophy, induced by the 
oil augmenting the bulk and quantity of the hepatic cells and 
supplying at once a material the more fitted for this secretion, 
because it has already within it some elements of biliary matter 
which served a similar purpose in the liver of the fish, and this 
at a lower temperature and less favorable to the activity of the 
process. The observation of this influence of cod-liver oil has 
led me to use it in several cases of functional and structural 
disease of the liver, marked by defective or depraved secretion, 
and in some instances with most satisfactory results, especially 
in one of habitual formation of gall-stones, which had resisted all 
kinds of treatment and was rapidly destroying the health : the 
use of the oil has entirely stopped the attacks, and has restored 
the patient to good health. 

" It appears probable, therefore, that although other oils might 
be equally influential in promoting nutrition, and in preventing 
and removing the cacoplastic and aplastic exudations of scrofu- 
lous subjects, the oil from the cod's liver, and perhaps those from 
the livers of other fish, have the advantage in point of digesti- 
bility, and in promoting the action of the digestive and biliary 
organs. 

u 3. Preparation and Administration of Cod-Liver Oil. — It 
may seem somewhat strange that this remedy, which has been 
long employed and valued on the continent, and in some limited 
localities in this country, and of late years has been strongly 
urged on the attention of practitioners both at home and abroad, 
should have been so slow in being received into general use. If 
the experience of other practitioners accord with my own on 
this point, I would give, as the reason of this tardy introduction, 
the disgusting smell and taste of the oil as it has been commonly 
prepared, and an impression generally prevalent that the efficacy 
of the remedy is connected with these offensive properties. 
This notion was favored by Dr. Hughes Bennett, in his mono- 
graph published in 1841. At that time I made several trials of 
the oils, selecting the clearer specimens of the brown oil as re- 
commended ; but I found that so few patients could take it at 
all, and a fewer still were able to persevere with it, that the 



358 HOW TO GET THE BEST OIL. 

inference seemed to be that however German and Dutch 
stomachs might bear it, English ones could not, at least among 
the upper classes. It was not until I had witnessed some strik- 
ing examples of benefit ensuing from the use of the pure oil, 
prepared according to Mr. Donovan's method, that I began 
again to make trial of it, and to reflect further on its mode of 
operation when freed from all impurities. The value of the oil 
will be much increased by the statement that in all instances I 
have prescribed it as free from taste and smell as could be pro- 
cured; and so little difficulty has been experienced in its ad- 
ministration that the proportion of cases in which it has decidedly 
disagreed has not amounted to four per cent. 

" The inoffensiveness of the oil implies the use of no process by 
which it can be deprived of its proper qualities. All that is re- 
quired is to obtain it pure and fresh, as it existed in the hepatic 
cells of the healthy fish when alive, without contamination by 
any process of putrefaction, roasting, boiling, or the like. On 
the contrary, the disgusting smell and taste and dark color of 
the impure oil proceed from the putrefaction and heat to which 
the livers are subjected for the purpose of obtaining from them 
the utmost quantity of oil; hence it becomes highly rancid, and 
holds in solution or suspension various putrid and coloring 
matters derived from the corrupting cells and tissues of the 
liver. 

"It is not my intention to describe the details of the process by 
which the oil may be obtained in the greatest purity ; but I may 
mention the following particulars, to which it is necessary to 
attend in order to obtain a good product. The livers should be 
used as soon as possible after the death of the fish, every hour 
deteriorating the quality of the oil. The pale, plump livers 
should be preferred; those which are flabby and dark in color 
should be rejected as unhealthy. The livers, after being quickly 
pounded into a pulp, should be mixed with water of the tempe- 
rature of about 120°, then filtered; and, after standing long 
enough, the oil is to be decanted from the filtered liquor, cooled 
to the temperature of 50°, and again filtered. The whole process 
is to be accomplished with as little delay as possible, and in 
closed vessels, to prevent the air from giving to the oil the slightest 
degree of rancidity. For the same reason, the vessels in which 
the oil is preserved should be full, well corked, and kept in a 
cool place. I recommend the second filtration after cooling, to 
remove the more solid part of the oil, the stearin and margarin, 
which not only further clears the oil by its separation, but, by 
leaving a preponderance of elain, gives to it more of that per- 
fectly liquid and penetrative quality which promotes its absorp- 
tion and diffusion through the fluids and tissues of the body. 



THERAPEUTIC USES OF THE OIL. 359 

My usual mode of administering cod-liver oil is in doses of a 
teaspoonful, gradually increased (if the stomach bear it) to a 
tablespoonful, floating on some pleasant-flavored liquid, such as 
diluted orange wine, or the infus. aurantii comp., with a little 
tinct. and syr. aurantii. The vehicle should be suited to the 
taste and stomach of the patient; and much of our success in 
exhibiting the medicine will depend on our being able to keep 
the palate and stomach at peace with the oil. In numerous in- 
stances I have found that the addition of a little diluted nitric 
acid to the vehicle will make it more grateful to the palate as 
well as serviceable to the stomach ; and we may often combine 
with it other medicines which are not disagreeable, and thus 
fulfil the indications of palliating symptoms by their means. 
The fittest time for taking the oil is from one to two hours after 
the three first meals of the day. At this time the chyme is be- 
ginning to pass from the stomach into the duodenum; and it 
would appear that the oil passes quickly with it, for given at 
this time it causes none of those unpleasant eructations which 
are apt to occur when it is taken either before or with food. 
There is nothing in the oil for the stomach to digest ; and the 
less it is brought into contact with it, and the sooner it passes 
out of it, the better. When it mixes with bile and pancreatic 
juice in the duodenum its division and absorption begin and 
proceed as in the case of all fatty matters. Herein, too, 
we see a reason why the oil does not agree so well either 
with the palate or stomach, when mixed in an emulsion, or 
combined with liquor potassse, as recommended by some prac- 
titioners. 

"In conclusion, I repeat, that further observations and longer 
time are requisite to determine with accuracy the extent to 
which this agent can control or remove tuberculous disease of 
the lung; but I would state it as the result of extensive expe- 
rience, confirmed by a rational consideration of its mode of 
action, that the pure fresh oil from the liver of the cod is more 
beneficial in the treatment of pulmonary consumption than any 
agent, medicinal, dietetic, or regiminal, that has yet been em- 
ployed." — London Journal of Medicine. 

The above statements are fully corroborated by the more 
recent experience at the Brompton Hospital, England ; which 
shows that the cod-liver oil has more power over pulmonary con- 
sumption than any agent hitherto employed. (See Braithwaite, 
part xx.) 

The salutary action of the oil, applied externally, has excited 
considerable interest in the profession. It was tried, in the first 
instance, as an experiment, on some favorite dogs affected with 
painful skin-disease. Then its powers were tested on sheep and 



360 ALTERATIVE ACTION OF THE OIL. 

other domestic animals. In Sweden it was first tried on the 
human subject as a local appliance, and afterward became a part 
of English practice. In chronic eruptions of various kinds, 
which under the legion titles of writers are not a little obscured, 
in the troublesome itching attendant on disease in old persons, 
the use of cod-liver oil by gentle friction, or even bathing, has 
appeared to be efficient. And even in cases of phthisis, in the 
early stage, where the internal use could not be tolerated, the 
persistent application of the oil over the entire chest has given 
obvious relief. Employing it thus, we have a better opportunity 
for administering such internal medicines as may be deemed 
advisable. 

Not only has the external inunction with cod-liver oil been 
serviceable in abating the symptoms of chest-disease, scrofula, 
&c, but it has been shown by Dr. Simpson that it affords a good 
degree of protection against tuberculous disorders, and may keep 
them at bay. An alleged discovery by Winckler, that it contains 
a peculiar fatty base (prophyline) instead of glycerine, of the 
other oil, may perhaps give a clue to its undoubted superiority. 
— Headland's Action of Medicines, p. 350. 

The archives of the Academy of Medicine of Madrid contain 
a paper by M. Manas, on the use of cod-liver oil in tertiary 
syphilis in persons of strumous habits. A very remarkable 
case is cited setting forth the happy agency of this medicine. 
It is stated that Dr. Copland has employed the article for the 
same object, having previously exhibited the iodide of potassium 
in similar cases. (See London Lancet, June, 1850.) 

The success of cod-liver oil in the treatment of chronic rheu- 
matism has been great beyond the fondest anticipations. The 
Grazette Medicate de Paris for 1847 contains the testimony of 
more than ten distinguished physicians, who have proved its 
value by repeated exhibition of the article. They regard it as 
possessed of more decided anti-rheumatic power than all other 
remedies heretofore employed. The cases reported embrace 
many individuals who, after years of suffering and the repeated 
trial of all sorts of remedies, were permanently cured by the 
fish oil alone. They speak, especially, of very obstinate cases 
of sciatic rheumatism managed most happily by the same medi- 
cine. I may add that several exceedingly obstinate cases of 
rheumatism that came under my own observation were speedily 
cured by the use of this oil. It is certainly entitled to the 
special notice of the profession. 

In swellings of the lymphatic glands, most probably of a 
scrofulous origin, in confirmed scrofula, in the management of 
scrofulous ulcers, and in correcting the scrofulous diathesis, Drs. 



THERAPEUTIC USES OF THE OIL. 361 

Brefeld and Galama feel confident that no agent is so potent and 
successful as the cod-liver oil. 

The reports differ a little in regard to the efficacy of this 
remedy in chronic exanthemata, associated with a scrofulous 
diathesis. Some affirm that the remedy has succeeded only 
when used externally, while others advocate its internal exhi- 
bition exclusively. Dr. Guerard professes to have cured very 
obstinate cases of scald head merely by anointing the diseased 
parts with the oil, so as to keep them constantly under its action. 
Dr. Hauf reports a case of humid herpes, attended with intole- 
rable pruritus, which after having resisted all kinds of treatment 
yielded to the oil, applied daily with gentle friction. 

The anti-scrofulous action of the oil led, we presume, to its 
exhibition in rachitis, (rickets of infancy,) which is essentially 
a disease of scrofulous origin. The German and Dutch phy- 
sicians have been extravagant in their commendations; but we 
regard the testimony of Bretonneau and Trousseau as more 
reliable. The latter gentleman, speaking for both, says, a We 
have often obtained cures the rapidity of which surpassed our 
expectation. Sometimes, after four or five days of treatment, 
the sharp pains felt by the children in all their limbs vanished; 
and the bones, which could be bent, acquired, at the end of five 
days, a considerable solidity." 

The very minute quantity of iodine in the oil has been made 
an objection to the position taken by some that it acts in virtue 
of its iodine, assisted by its bromine. The mere modification 
by combination will often accomplish wonderful results, even 
though there be employed a very small portion of active agents. 
This is exemplified in medical practice continually. 

The therapeutic quality of cod-liver oil is not, perhaps, well 
settled. I suppose it may be regarded in the light of an alter- 
ative, and as such gradually improving the quality and condition 
of the blood, and thus ultimately exerting a salutary influence 
on tissues and organs in a morbid state. That it acts also 
particularly on the glandular and absorbent system is highly 
probable. I have never known it to purge, even in large doses, 
nor to induce any unpleasant result. 

As it may sometimes be desirable to exhibit a combination of 
cod-liver and sulph. quinine, the following mode of preparing 
the compound will be found useful. 

Two drachms of disulph. quinine are to be dissolved in half a 
pint of water, acidulated with two drachms of dilute sulphuric 
acid ; then precipitate by adding liq. ammonia, 5iss. Throw the 
whole on a filter, and wash the precipitate with four or five ounces 
more of water. Dry the precipitate well ; place it in an evapor- 

24 



362 USES OF COFFEE. 

ating pan and set it over a steam-bath. The heat will cause 
the quinine salt to melt and separate from the residual water. 
This should be poured off and the solid matter collected by filtra- 
tion, then powdered and set aside for use. 

To prepare the oil, take sixteen grains of the above product 
and dissolve, with gentle heat, in eight ounces cod-liver oil. 
The latter will become slightly colored. This is best obviated 
by dissolving the quinine product in a mixture of one drachm 
each of sulphuric ether and alcohol, mixing the solution with the 
oil and evaporating by means of a steam-bath. If the oil re- 
quires filtration, it should be passed through lint loosely placed 
on the neck of a funnel. Every ounce of oil will contain two 
grains of the salt of quinine. 

A good deal has been written about the best tests of pure and 
genuine cod-liver oil. All this may do well enough for the phar- 
maceutist, but will not be of much worth to the country doctor, 
whose whole time is demanded by the practical duties of his call- 
ing. The simplest of all the tests, I suppose, is sulphuric acid 
of the most concentrated kind. If one or two drops be added to 
half a teaspoonful of oil spread out on a white porcelain plate, it 
will strike a beautiful violet color, which passes to a purple the 
moment the mixture is agitated, and finally to a rich sienna 
brown. But the surest test is to purchase the article of the 
druggist who stands highest for probity and acquaintance with 
the business, and never to be gulled by a cheap thing. 

Coffee. Coffea Arabica. Quhwa of the Arabs. — Though a 
native of Arabia and Abyssinia, it has been cultivated in various 
countries with success. It is too well known to require special 
notice as to its natural history or general qualities. A remark- 
able fact has been developed, showing its similarity to tea in the 
circumstance of caffeine, the proximate principle of coffee being 
identical in composition with theine, the proximate principle of 
tea. Coffee has been and is now regarded as a stimulant and 
antisoporific, the latter term referring to its agency in counter- 
acting the effects of opium and other narcotic poisons. This use 
of coffee was common in this country forty years ago, and 
several theses were printed by the University of Pennsylvania 
on this point. Very strong decoctions of coffee, without any 
addition, were employed for this end. All opium-eaters are great 
coffee-drinkers, and, for this reason, Beaujour, in his work on 
Greece, records the history of an opium-eater who drank more 
than sixty cups of coffee in a day and smoked as many pipes. All 
this was designed to counteract the pernicious action of the opium. 

By diminishing congestion of the brain, tea and coffee have 
not only the effect of clearing the mind, but in large quantities 
they induce wakefulness, as the common people well know. This 



USES OF COFFEE. 363 

is peculiarly the case with coffee. It is not clear that tea, as 
commonly drank, is ever unwholesome. Green tea is a more 
powerful sedative than black, and resembles coffee. Coffee has 
a more potent influence over the mind and nervous system than 
tea, and is more apt to disagree with many persons. It is by 
virtue of its power to lessen congestion of the brain, induced by 
opium, that strong coffee is of use in cases of poisoning by that 
agent, and not chiefly, as some imagine, by reason of chemical 
agency. — Headland's Action of Medicines, p. 281. 

Much attention has been paid to the potent agency of coffee, 
tea, and cocoa, but especially of coffee, in lessening the elimina- 
tion of urea. The late observations of Dr. Julius Lehman show 
that coffee has two powerful actions in health: it increases the 
nervous energy and protracts the metamorphosis of tissue. — Med. 
Tiines and Gazette, June, 1855. 

Liebig has shown that caffeine and theine furnish the taurine 
of bile to a large extent. Hence tea and coffee are held to be 
"bilious," emphatically, by many. 

The Edinburgh Medical and Surgical Journal for January, 
1842, has a case of poisoning by one and a quarter grains of 
sulphate of morphia, equal to seven and a half grains of opium, 
cured by gill doses of strong decoction of coffee frequently 
administered. 

Very strong coffee, unmixed with sugar or cream, was the 
favorite remedy of Sir John Pringle for his own asthma and 
that of others. It is specially suited to the disease in old per- 
sons with enfeebled constitutions. Here it acts partly as a 
stimulant, antispasmodic, and expectorant, and is given in table- 
spoonful doses every half hour. One of the best uses of coffee 
that I know of is as an antiemetic ; not merely in cases of over- 
dosing with tartar emetic, when its effects are owing to its tannin, 
but also in irritable stomachs from other causes. A tablespoon- 
ful of the strongest decoction, unmixed, should be given every 
ten or fifteen minutes. Often this has succeeded when other 
means were unavailing. 

At a meeting of the Suffolk District Medical Society in Feb- 
ruary, 1852, Dr. Adams stated that intermittents had been cured, 
after all other means failed, by the use of strong coffee and lemon 
juice. Dr. Bigelow said that the same means were successful in 
the mountains of Peru. Dr. Cabot declared that he had cured 
himself of the same disease in Yucatan in the same way. — Boston 
Med. and Surg. Journal, March 10, 1852. 

Coffee has been very successfully employed in cholera in- 
fantum. Dr. Pickford has furnished an interesting article in 
this relation in the Medical G-azette of London for November 
24, 184%. For an infant at the breast a scruple of roasted 



364 COLCHICUM AUTUMNALE. 

coffee was infused in two ounces of water, adding an ounce of 
syrup. A spoonful of the mixture was given every hour, with 
the effect of arresting the vomiting and purging in a few days. 
Combined with opium, coffee has been a favorite medicine with 
the Germans in bilious diarrhoea. I know nothing of the value 
of coffee, in the treatment of infantile cholera, from experience, 
but am disposed to think well of it, alternated with minute por- 
tions of calomel. 

Dr. Julius Guyot has published an interesting article in 
It Union Medicate of April, 1849, setting forth the remedial 
powers of coffee in the treatment of hooping-cough most con- 
clusively. It was tried in more than sixty cases, and many ot 
them of the worst kind. An ex-notary had been obliged to 
have double doors made for his study to keep out the noise of 
his coughing children. Both were cured in four clays by the 
coffee, in teaspoonful doses, frequently taken. Dr. Guyot re- 
gards the disease as confined to the pharynx and stomach, and 
thinks the coffee acts by allaying irritability there. (See Braith- 
waite, part xx.) 

The fumes of fresh-roasted coffee are said to be decidedly dis- 
infectant, but I suppose we have more efficient agents for the 
same end. (See Braithwaite s Retrospect, part xvii. p. 304.) 

The last use of coffee to be named is as a vehicle for the 
administration of Epsom salts. If we add a half-ounce to a tea- 
cupful of strong coffee the unpleasant taste of the salt will be 
completely neutralized. The same expedient nearly obliterates 
the bitterness of the sulphate of quinine. 

Colchicum. Colchicum Autumnale, Meadow Saffron. — 
This plant is a hardy perennial, growing in meadows, and 
having a purple flower in September. The root is bulbous, 
and decays after flowering ; and the new and recent roots are 
in perfection from June to September. Pelletier and Caventou 
were the first to extract from the juice of the roots a peculiar 
salifiable base called veratria or veratrine. Locality and climate 
exert much influence on the plant. Maranta and Haller say it 
is sweet, or tasteless and inert in autumn, and may then be 
eaten. Krapf says it is eaten in autumn in Istria : yet so acrid 
is the juice that Storck affirms that by rubbing some on his 
tongue it was swollen and became rigid and numb for several 
hours. Though the bulbs have been eaten with impunity, yet 
the whole plant is sometimes poisonous. A man took the flowers 
for ague and fever, and suffered severe pains in the bowels for 
several days. Two boys were killed by eating the flowers while 
playing in a field where the colchicum grew. The seeds 
have proved poisonous in several instances when swallowed by 
mistake. 



COLCHICUM A POISON. 365 

Deleterious as this plant sometimes is, it is rendered perfectly 
mild by pickling, and then is eaten as a condiment by the natives 
of the Cape of Good Hope as well as by the colonists. (See 
Thunbergs Travels, vol. ii.) The British Medical Flora, vol. i., 
asserts that long boiling renders colchicum much more mild, by 
dissipating the offensive matter adhering to the pulp. The same 
is true of some other vegetable substances. 

The season of the year also has an obvious effect on the ac- 
tivity of the article. The acetic solution of colchicum made of 
the roots taken in February is very energetic, while that made 
from roots taken from the same garden in August* and Septem- 
ber is void of power. (See Dublin Medical Transactions, vol. 
ii. p. 268.) 

The wine of the bulbs, in an overdose, is decidedly poisonous. 
A man took an ounce and a half of the vinous tincture by mis- 
take, and died in forty-eight hours. He suffered severe vomiting, 
acute gastric pains, colic, purging, and delirium. Schobel, a 
German physician, affirms that colchicum is poisonous to all ani- 
mals, and that it acts fatally whether injected into the windpipe 
or put into a wound. The uniform symptoms of poisoning by 
colchicum are distressing sickness, vomiting, purging, pain and 
heat of the stomach and bowels, tenesmus, strangury, and hic- 
cough. Dissection shows extensive inflammation of the mucous 
membrane of the bowels and stomach. 

The following cases, furnished by Surgeon M'Phail, of the 
U. S. Army, and published in Dunglison s Medical Intelligencer, 
vol. ii., sets forth not only the ease with which a fatal mistake 
may be committed, and likewise the energetic character of col- 
chicum as a medicine, but also clearly displays its terrible power 
as a poison. It is matter of regret that the pressure of official 
duties prevented a post mortem examination : — 

"I found," says the doctor, " on my arrival at Fort Denaud, 
(in Florida,) J. A. P., a private in the marine corps, laboring 
under symptoms not unlike those of Asiatic cholera. He had 
constant sero-mucous ejections and purgings resembling rice- 
water, and thrown off with considerable force ; cramps of the 
abdominal muscles and of the flexors of the arms and legs ; cold 
surface, tongue, and breath ; mottled skin and bluish nails ; 
shrunken features, expressive of great agony ; sunken and 
watery eyes, with contracted pupils. Expressing my surprise 
at the state of the patient, I was shown a porter bottle labeled 
vinum colchiei, and was told that he, being an hospital attend- 
ant, and thus having access to the stores, had, with some of his 
comrades, exhausted the whole stock of liquors, and feeling the 
'horrors' coming on, searched for more stimulus. Judging by 
the smell only he took what he thought was a bottle of Madeira. 



366 NO ANTIDOTE FOR IT. 

With characteristic generosity he gave a glass to some of his 
comrades, telling them to make the most of it as he believed it 
to be the last, and then swigged off the remainder, which was 
over a pint. Little did he think, when he jested about the last 
glass, that it would really prove so to himself and two others, 
and seriously affect a third. Three have fallen victims, if not 
directly to the vice of intemperance, — which is the besetting sin 
of the army, and the origin of most crimes that call for punish- 
ment, — at least to one of its consequences, the loss of moral 
feeling leading to theft. 

"When first seen, J. A. P. was beyond hope, as the poison 
had been taken on the day previous, (February 1, 1838,) and he 
was now laboring under its uncontrollable effects, viz., violent 
inflammation of the stomach and bowels, and probably of the 
cerebro-spinal serous envelops. Death took place in forty-eight 
hours after the poison was swallowed. 

" Corporal P. and private T., both of the marine corps, came 
on the sick report February 6, with symptoms indicating dysen- 
tery, viz., sanguineo-mucus stools, great tormina and tenesmus, 
with cramps of the extremities. I did not know until several 
days had elapsed that they had been companions in the affair 
of J. A. P. Cupping, vesication, fomentation, warm bathing, 
dieting, mucilaginous drinks, &c. &c. all proved of no avail. 
They were sent to the general hospital at Tampa Bay for change 
of air and better accommodations, but with the tongue and 
fauces indicating an incurable condition of the mucous apparatus 
of digestion. Both died in a few weeks." 

In medical practice, both public and private, similar symptoms 
have followed the exhibition of too large a dose of the wine of 
colchicum. Dr. Levins says that he has known two drachms to 
prove fatal in a public hospital. He saw one hundred drops in- 
duce six or eight watery motions, with considerable griping and 
great commotion in the colon. In the conclusion of his remarks 
he puts this interrogatory with much earnestness, viz. : — "When 
the abnormal or poisonous effects of colchicum happen, have we 
any certain means of arresting them ? The reply is, We have 
no such means. Opium and cordials may sometimes check the 
enormous vomitings and purgings, but we should be very sorry 
to incur the risk of these correctives." (See Medico-Chirurgical 
Review, April, 1837.) 

The seeds of colchicum have killed children who ate them, 
ignorant of their properties ; and cattle have been also injured 
by them, but only in the spring, when the seed is fully matured. 
A writer in the seventh volume of the Edinburgh Annual Re- 
gister says that a farmer lost seven yearlings out of eighteen, 
by putting them in a field where the plant was abundant. On 



SYMPTOMS OF POISONING. 367 

opening them after death, the food was found clogged together 
in a crude and undigested mass, incapable of passing through 
the proper duct. 

The following notice of accidental poisoning is from a Phila- 
delphia newspaper of 1839 : — " A family by the name of Kean, 
consisting of a mother and five children, and residing in that 
county, was poisoned by drinking a tea made of meadow saffron, 
which had been gathered by the children, supposing it to be 
spikenard. Immediately after drinking the tea every member of 
the family was affected with a giddiness in the head and pain in the 
stomach, followed with convulsions. Drs. Cossitt and Brainard, 
of Greenville, were sent for, but arrived too late to render any 
relief to Mrs. K., who died in a few hours after she was taken 
sick. Of the others, three were considered out of danger, and the 
recovery of two very doubtful." 

We remarked that we knew of no case of the administration of 
colchicum with murderous intent ; but there have been several 
attempts at suicide, and some of them successful, by this means. 
A female, as we learn from Burnet's Medical Botany, vol. ii., 
took an infusion of colchicum to cause abortion. The symptoms 
were such as we have named. The result was achieved by the 
following day, but she died in a few hours after. In this case 
dissection revealed no marks Of morbid action excepting in the 
stomach and intestines, where marks of high inflammation were 
obvious. In a fatal case reported by Dr. Thompson, blood 
flowed from every mucous surface of the body. 

In the Archives Crenerales for 1837, we notice the cases of 
two sisters who fell victims to the poison of colchicum. The first 
took a large wineglassful of the tincture of the bulbs of colchi- 
cum, and died in twenty-two hours after the poison had been 
swallowed. The other sister in a few months after, and with a 
full knowledge of what had happened, took between four and 
five ounces of the tincture, and was dead at the end of twenty- 
eight hours. In neither case were the evacuations considerable. 
Cramps very painfully affected the feet of both patients, and 
there was great pain in the epigastric region, dyspnoea, and 
general coldness, with constant retching ; pulse small and very 
feeble ; pupils not affected, and mental powers undisturbed. The 
remedies tried were milk ; iced drink, as lemonade ; emollient 
clysters ; blisters to the extremities ; sinapisms over the stomach, 
preceded by leeches. 

The root and seeds are very seldom employed in practice in 
any other shape than that of a tincture, of which there are two 
varieties. These are prepared with wine and vinegar, or acetic 
acid, because they are the best solvents of the plant. The 
vinous solution, no matter how well got up, is liable to sponta- 



368 DOSES OF COLCHICUM. 

neous decomposition, which causes a copious sediment ; while the 
acetic solution is free from this defect, and can be kept a great 
length of time unchanged. To make it, one ounce and a half 
of the dried root must be macerated in twelve ounces of the 
strongest vinegar or in acetic acid, for a week or ten days. The 
filtered liquor should be kept in well-stopped bottles. The dose 
for an adult is from thirty to sixty drops, according to the end 
desired. Either the root or seeds may be employed to prepare 
this tincture.* 

In addition to these fluid mixtures there is an acetic extract 
that is sometimes employed and contains all the powers of the 
plant. To prepare it, rub the corms or bulbs of the colchicum 
to a pulp to the quantity of a pound, and gradually add of acetic 
or pyroligenous acid three ounces. Express the liquid and evapo- 
rate it in an earthenware vessel not glazed with lead, to the 
proper consistence. The dose is from one to three grains three 
or four times a day. 

Colchicum has long been celebrated in the treatment of gout 
and rheumatism ; and many have imagined that the effect was 
due to some mysterious specific action. The Eau Medicinale 
D'Husson, so famous for gout in former years, did much to popu- 
larize this notion. Under the same impression it has been em- 
ployed often to relieve spasmodic affections of the chest which 
were cardiac or rheumatic, or both. 

I do not believe that this medicine ever cures by any sort of 
specific influence, though its mischievous effects are doubtless at- 
tributable to an agency that is specific enough. Unless the medi- 
cine excites nausea and vomiting or purging, or both, or be com- 
bined with other articles that can and do exert an alterative 
power, I doubt whether it is ever remedial in the proper sense of 
the term. In doses of sixty drops, and above that quantity, 
purging and vomiting are generally induced, and sometimes with 
severity. 

Colchicum has many different actions, says Headland in his 
work on the Action of Medicines, page 279. It has an obvious 
agency in changing the blood in gout, and has been hence called 
an antiartliritic. It is decidedly eliminative, acting on the liver 
and bowels so as to rid the system of morbid matter. It is, 
also, a general sedative. When it kills, it is not by a true nar- 
cotic power, but, like other sedatives, it operates by inducing 
syncope. Its features of cumulation and toleration, which should 

* All the tinctures of colchicum should be kept in a dark place, wrapped in 
paper or in opake bottles, so as to exclude the light. The bulbs, the tinctures, 
and the wine all become inert by long keeping, and especially by exposure to 
the light. — Dr. Armstrong' s Practice. 



DOSES OF COLCHICUM. 369 

ever be remembered, are manifest in other articles that go under 
the name of nerve-medicines ; such as aconite and digitalis. 

Just here it is proper to call attention to the great discrepancy 
in the profession touching the dose of colchicum. This point is 
fully noticed in a paper in the Edinburgh Medical and Surgical 
Journal for July, 1841, in which it is shown that the doses as 
employed by very distinguished physicians varied from twenty 
drops to a half-ounce of the acetic tincture. This fact is amply 
confirmatory of the remark already made, that the plant is vigor- 
ous in one part of the year and inert a few months later ; and 
consequently that the tincture prepared from such variant mate- 
rials must be of very different strength. 

The author of the above paper gives the following details, 
which we are sure will be interesting to our readers : — 

"The editor of the Medico- Chirurgical Review some few 
years since expressed his disbelief that a drachm of the tincture 
of colchicum seeds, given every three hours, would prove fatal. 
The late Dr. Duncan, in his Dispensatory, has stated that half 
an ounce of the tincture of the seeds is the proper dose. In 
Dr. Spillan's late collection of medical prescriptions, a draught 
containing, among other things, half an ounce of the tincture of 
the seeds, is ordered to be taken every sixth hour. Dr. Elliot- 
son directed half a drachm of the wine of colchium seeds to be 
taken thrice a day for three weeks. Dr. Barlow, of Bath, ad- 
vises from one to two drachms of the tincture of the seeds to be 
given at night, and, if need be, on the next morning. 

u Dr. Lewins remarked that he knew a case in which two 
drachms proved fatal to a patient in a public hospital ; and he 
states the particulars of a case in which one drachm daily set up 
so violent a diarrhoea as to cause twenty stools in the course of 
a day. And he observes that if the patient had continued to 
take the medicine for twenty-four hours longer he would have 
perished." 

As large doses purge and vomit severely we can easily understand 
wherein the sedative and narcotic powers reside, or rather on 
what they depend. The last flow naturally from the former, and 
if not promptly met will soon destroy life. It is on the same 
principle that the medicine so frequently allays febrile excitement 
and pain. Sometimes it seems to act as by a charm, and so 
promptly that it would appear that the effect depended on 
nervous communication exclusively. I once gave it to a young- 
man laboring under spasms of the chest, and suffering severely, 
in forty-drop doses, with almost instantly good result ; and 
there was no obvious sickness of stomach and no purging. In 
this case the action was probably sympathetic from the stomach 



370 HOW IT ACTS IN GOUT. 

to the chest, and all this from nervous communication by the 
par vagum. 

A French physician attempted to explain the action of col- 
chicum in the treatment of gout and rheumatism, by its tendency 
to increase the quantity of uric acid in the urinary discharges, 
or rather to eliminate the excess of this acid from the system in 
this way. This physician regarded uric acid as the cause of 
gout and rheumatism, and his views were published before the 
papers of Dr. Todd, and others who have recently contended for 
the same doctrine. He gave from twenty to thirty drops in half 
a wineglass of water, and increased the dose until gastric irrita- 
tion was established, that being the necessary precursor and 
associate of the elimination of the uric acid. 

As the liver is often at fault both in gout and rheumatism, it 
may be serviceable occasionally to combine the colchicum with 
blue mass and ipecacuanha. I have adopted this course in cases 
of pericarditis, with shifting rheumatic pains, in lads of twelve 
years, and with good results. Thus : — 

R. — Acetic extract of colchicum, 
Blue pill mass, aa gi ; 
Powder of ipecacuanha, gss 

Mix, and divide into thirty pills, one to be taken three times a day. 

Since the treatment above named I had a case of severe peri- 
carditis, in a boy aged thirteen, at the clinique of the Phila- 
delphia College of Medicine. It was complicated with some 
hypertrophy, and the whole resulted from a severe rheumatic 
fever. The patient came under treatment in May, 1849, had 
severe and distressing palpitations frequently, with evident fric- 
tion sound, and his look was that of a dropsical person, although 
there was no effusion. His pulse was unusually frequent and yet 
tense, and the respiration embarrassed. He had severe pain in 
the region of the heart occasionally. He was put on the formula 
above named, and which was rigidly adhered to for several weeks, 
and then altered thus : — 

R, — Acet. extract colch. ^ij ; 
Hyd. mass, ccerul. ^ss ; 
Ant. tartarisat. grs. ij. 
M. ft. pil. xx. Take one night and morning. 

He was kept all the while quite sore on the cardiac region by 
the use of the pustulating liniment, prepared as follows : — 

R. — 01. croton. tigl. £ss : 
Antim. tartar, ^i ; 
01. olivar. !|ss. 
Mix, and rub smartly on the cardiac region. 



THE ACETIC EXTRACT. 371 

A farinaceous diet was ordered, and constant quietude ; to 
keep the feet dry, and to be clothed in conformity to changes of 
weather. 

Under this management he improved rapidly, and by January, 
1850, there was no unusual sound in the heart, the pulse was 
natural, respiration as in health, and an actual gain in flesh. 
The medicine did not excite ptyalism, nor any tenderness of the 
gums, and the bowels continued perfectly regular. 

From the above statements it may be inferred that the real 
action of the colchicum was merely alterative, and hence some 
have assigned it a place among alteratives. That it induces im- 
portant changes is doubtless true, yet it is well to know something 
of the nature of these changes, and to watch them with care. 
On this principle of action I presume the medicine acts in curing 
leuchorrhoea, a disease successfully treated by Dr. Ritton, who 
employed the powdered root made into pills with soap. Each 
pill contained three grains of colchicum, and three pills consti- 
tuted the dose, which was gradually increased to five or six. 
The mean length of time requisite for successful issue was about 
ten days. During this treatment all stimulating drink and diet 
were prohibited. 

Dr. Ficinus, of Dresden, confirms the opinion of Eiseman, of 
the value of the wine of colchicum in gonorrhoea. He gives 
from twenty-five to thirty drops thrice a day, combined with 
laudanum, enforcing at the same time a low diet, the warm bath, 
&c. These means have been remarkably successful in gonor- 
rhoea and other inflammatory discharges from the urethra of 
males and the vagina of females. The details of ten cases are 
given in illustration. (See Braithwaite.) 

In the same number of the journal just quoted the reader 
may find some very interesting statements on the treatment of 
enlarged prostate glands in old persons. After leeching the 
perineum, emptying the rectum by enemata, and the occasional 
use of opiate suppositories, the following pills were employed 
with decided benefit : — 

R. — Ext. colchic. acet. gr. i; 
Pill. hydr. mass. gr. i ; 
Pulv. Doveri, grs. v ; 
Ext. colocynth. comp. grs. iij. 
Mix. To make a pill, or two if one be too large. 

To be taken twice or thrice in twenty-four hours, and continue 
for several weeks. The medicine acts as an alterative and a 
promoter of absorption. If a catheter must be used, it is sug- 
gested that an elastic instrument be selected. 

The proximate principle veratria, or veratrine, or colchicine, is 
entitled to some consideration. The various species of veratrum, 



372 VERATMA. 

as well as colchicum, contain this principle in the form of gallate 
of veratria, and the connection being easily broken between the 
acid and base, pure veratria is readily obtained. From whatever 
source procured, it is scarcely soluble in cold water, and even 
boiling water dissolves only a thousandth part, the solution being 
obviously acrid. It is very soluble in sulphuric ether, and more 
so in alcohol. It is insoluble in solutions of alkalies, but dis- 
solves freely in the vegetable acids, forming salts which do not 
crystallize. The taste of veratria is very acrid, but not bitter; 
it excites free salivation, even in minute quantities, and hence 
it has been called a sialagogue. It is quite inodorous, and 
in attempting to test this point great care should be taken, as 
the smallest portion drawn into the nostrils will set up violent 
sneezing. 

Of all the salts. of veratria the acetate is the most active. A 
grain and a half injected into the tunica vaginalis or the jugular 
vein causes death in a few seconds, preceded by violent tetanic 
spasms. A quarter-grain given to an adult will produce very 
copious alvine discharges, and a dose rather larger will excite 
vomiting. Of course it is emetic and cathartic. Magendie gave 
two grains in the course of twenty-four hours to an old man 
laboring under apoplexy, but the medicine did not act on the 
bowels, because they were probably paralyzed. Applied directly 
to the mucous membranes anywhere, it is highly stimulant. 

Dr. Turnbull has written much on this article, and in fact 
made it a hobby for a long time, regarding it in the light of a 
panacea. As it is a very energetic medicine, there can be no 
doubt that it did sometimes induce the results of which he speaks. 
The external use seems to have been successful in many instances, 
and it is decidedly the safest mode of exhibition, Four grains 
rubbed with an ounce of lard and applied by friction to the 
abdomen of a dropsical patient, cured him in fourteen days. The 
frictions were made night and morning. Tic douleureux and 
rheumatism were cured in the same way, from twelve to fifteen 
grains of the veratria being mixed with an ounce of lard and a 
portion of the size of a nutmeg rubbed into the affected part 
morning and night. The Provincial Medical and Surgical 
Journal for August, 1841, speaks well of it in spasmodic affec- 
tions of the larnyx and its appendages, which were probably 
neuralgic. In these cases the ointment consisted of a scruple 
of veratria to an ounce of simple cerate, of which a small portion 
was rubbed on each side of the cervical vertebrae twice a day. 
The cure was complete in two months. Dr. Buchanan, of Eng- 
land, advocates the external use of veratria in dysmenorrhoea. 
A half-drachm of veratria is well triturated with an ounce of 



COLLODION, ITS USES. 373 

lard and a lump as large as a hazelnut rubbed on the sacrum 
three or four times a day. 

Turnbull says the addition of four grains of veratria to an 
ounce of the strongest tincture of red pepper makes a most 
energetic counter-irritant and rubefacient. The pepper tincture 
named consists of four ounces of the pepper and twelve ounces 
of alcohol digested for seven days and then filtered. 

For internal use, the following directions are given by the 
same author : — Four grains added to an ounce of alcohol make 
a tincture the adult dose of which is from twenty to twenty-five 
drops in a cup of any simple drink. One grain of the acetate or 
sulphate of veratria dissolved in two ounces of distilled water 
makes a good substitute for the eau mSdicinale d'lTusson, and is 
employed as such in gout and rheumatism. Magendie offers the 
following formula : — 

R. — Veratria, a half-grain ; 

Powder of gum Arabic, five grains ; 
Simple syrup, q. s. 

To make six pills ; the dose is one pill night and morning. 

I have no doubt that the medicinal powers of this medicine 
have been overrated, yet its inherent energy justifies the opinion 
that it may be useful in judicious hands. 

Collodion. (From the Greek word colla, glue.) — This is a 
new article, made by dissolving gun-cotton in sulphuric ether. 
It has been claimed as an American discovery, but a foreigner 
affirms that he employed it several years prior to any notice of 
it in the United States. The solution looks not unlike mucilage 
of gum Arabic, but has a strong ethereal odor. Applied to the 
surface of the body, sound or otherwise, it has the appearance 
somewhat of mucilage, but dries more rapidly. It has the 
advantage over all other adhesive applications that it is not 
affected by water, cold or hot, acids, alkalies, nor anything with 
which it may come in contact. It remains on the spot until 
healing takes place, and separates as a new skin is formed. The 
application of it causes a slight sensation of heat, as ether alone 
would do, but this quickly subsides. 

To show the utility of this article, we name some of the cir- 
cumstances under which it has been successfully tried. In fissure 
of the nipples it has been found to protect the tender parts 
effectually, being applied, morning and evening, so as to coat 
the parts entirely. Even laceration of the perineum has been 
managed by the application of this solution, keeping the parts 
accurately united and resisting the action of the discharges in 
the vicinity. Cutaneous diseases have also been treated with 
decided advantage with the same article. A simple scratch of 



374 COLLODION, ITS USES. 

the hand, which often is troublesome in irritable habits, is most 
happily managed by coating it over with collodion, as I have 
proved in my own person. The wounded part is completely 
protected, ceases to be painful, and soon heals over. Incised 
wounds have been treated in the same way. 

It seems to be well suited to all the varieties of pruritus that 
are so exceedingly difficult to manage. It speedily arrests the 
bleeding from leech-bites, and is a good application to prevent 
pitting from smallpox. 

A mixture of twenty parts of collodion and six of castor oil 
applied over the entire scrotum quickly lessens the pain and 
swelling of orchitis, and gives a rapid and entire recovery. Pro- 
fessor Oostes relates several cases in point. 

From the most recent notices of this new article we make the 
following extracts : — 

Mr. Wilson says in a troublesome case of chapped hands and 
fingers, resulting from chronic disease, the collodium acted not 
merely as a protective covering, but promoted the healing of the 
cracks more quickly than any usual remedies. In chapped nip- 
ples it seemed to work a charm upon the painful skin. It is 
nowise injurious to the infant, because not in the least altered by 
the act of sucking. It cures small superficial ulcerations of the 
corona glandis and prepuce, resulting from accidental excoria- 
tions, very speedily. 

Many articles have appeared in the journals showing the good 
effects of collodion in treating burns and scalds. It has answered 
well in burns caused by explosion of gunpowder and by the 
firing of alcohol, the neck, breast, face, and hands all being im- 
plicated. Collodion was applied, one hour and a half after the 
occurrence of the accident, by means of a hair pencil. The red- 
ness, pain, and swelling were soon lessened, and no inconvenience 
was felt save the tension induced by the closely adherent pellicle. 
Inflammation entirely vanished, and recovery was rapid. The 
remedy acts by protecting the very sensitive cutis, and by fur- 
nishing a constant and equable support to the parts. 

M. Meynier (Bulletin de Therap., vol. xliv. p. 185) has suc- 
ceeded with collodion in cases of inverted toe-nail. He presses 
the flesh away from the nail and pours the collodion into the 
cavity. This very soon solidifies, induces rapid healing, and 
almost always cures. Four out of five cases so treated by M. H, 
Larrey were cured. This is a simple remedy for so painful an 
affair, and merits further trials. 

Chilblains and chaps are promptly relieved hj the following 
mixture, applied by means of a fine hair pencil freely to the 
parts : — Collodion, thirty parts ; Venice turpentine, twelve ; 
castor oil, six. — Bull, de Therap., Nov. 1856. 



375 

M. Legroux says (in X' Union Medicate, October, 1857) that 
the following preparation has been very efficacious in that pain- 
ful affection, sore nipples, already alluded to. He renders col- 
lodion elastic by the addition to thirty parts of collodion of half 
a part of castor oil and one and a half parts of turpentine. 
The mixture is to be applied around, but not on the nipple, by 
means of a fine hair pencil. Over the surface is to be placed a 
piece of goldbeater's skin, with pin-holes in it opposite the nip- 
ple, so as to allow the passage of the milk. Before suckling, 
the goldbeater's skin is moistened with a little sugared water, 
which gives it sufficient pliancy. If it should crack, replace it. 

In the London Lancet for December 9, 1848, we find very 
favorable notices of the use of collodion for arresting the hemor- 
rhage from leech-bites. Dr. Tucker dips lint in the collodion, 
lays it on the spots, and applies collodion over the whole with a 
camel's-hair pencil. Some advise pressure also for a short time, 
but it is hardly needful. 

M. Hairon has lately found collodion a very useful adjunct in 
the management of ophthalmic affections, and especially when 
he desired to keep some active article in contact with the eye 
and to exclude the light. The collodion keeps the lid closed, 
and the ends are attained perfectly. (See L' Union Medicale, 
No. 29.) 

In a paper read to the Academy of Sciences of Paris, M. 
Latour endeavored to show that any inflammation of the skin 
may be arrested by covering the inflamed integuments with any 
adhesive compound capable of excluding the air. Formerly he 
employed a solution of gum, but has now substituted collodion. 
Two cases of erysipelas treated with the latter agent were well 
in a few days. This notice is taken from the London Lancet, 
June, 1850. 

A mixture of thirty parts of collodion and two parts of castor 
oil has been very beneficially employed in erysipelas. The 
varnish made by this union is applied to the skin once a day for 
three days. It puts an end to the burning pain and the itching, 
and restores the natural color of the surface. The idea of such 
a mixture originated with M. Robert Latour. — Journal de Me- 
dicine, Nov. 1852. 

In consequence of the success attending the practice of paint- 
ing parts affected with erysipelas with collodion, the same remedy 
has been applied to cases of inflamed epididymus, especially re- 
sulting from the vice of onanism. Pencilling the scrotum with 
collodion has met these cases admirably, a single application 
sometimes sufficing, and the cure being obvious at the end 
of three or four days. — Medical Times and Gazette, May 
14, 1853. 



376 BITTER APPLE. 

Mammary abscess has been successfully treated by early 
painting the surface with this article ; and it has also been 
employed to prevent scarring in smallpox. 

In addition to the employment of collodion as a dressing for 
bed sores, it has lately been made an auxiliary to cantharides. 
M. Hirsch, of St. Petersburg, employs the following prepara- 
tion as a vesicatory when one is needed where it cannot be dis- 
turbed by the movements of the patient. He calls it cantharidal 
collodion, and makes it thus : — A pound of coarsely-powdered 
cantharides, a pound of sulphuric ether, and three ounces of 
acetic ether are placed in a vessel for digestion. A saturated 
solution of cantharides, with the green animal fatty matter 
blended with it, is thus obtained ; and in two ounces of this 
twenty-five grains of gun-cotton are dissolved and kept in close 
bottles. TVhen a blister is required it will be sufficient to smear 
with this fluid the surface to be vesicated. (See Braithwaite, 
part xx.) 

Caustic collodion has been employed by Dr. Macke, of Soran. 
for some years, to destroy noevi materni. It consists of a solu- 
tion of four parts deuto-chloride of mercury in thirty of collodion. 
The application is easily made with a fine hairbrush. It dries so 
quickly that it cannot spread. If it induce too much inflamma- 
tion, cold applications will be needful. The eschar is solid, and 
its thickness depends on the number of applications. It separates 
in from three to six days, leaving a trifling cicatrix. The pain 
is moderate and soon passes awav. — Dublin Hospital G-azette. 
July, 1856. 

A ferruginous collodion has lately been prepared by If. Aran, 
of Paris, because of the pellicle it makes being thinner than that 
of the common collodion, and also more flexible. Its adhesion, 
too, continues longer. It is made of equal parts of ordinary 
collodion and Bestuchef 's tincture of iron, (the ethereal tincture 
of per-chloride, or our muriated tincture.) — Braithivaite, part 
xxvii. p. 32. 

Colocyxth. Colocynthis Cucumis. Bitter Apple. Bitter 
Cucumber. — This is a trailing plant growing in Turkey and 
Nubia. The ripe fruit is about the size of a medium orange, 
and looks, not very unlike it. The dried pulp is white, light, 
spongy, very soluble in water, forming a mucilaginous and very 
bitter solution, which by evaporation yields the extract of colo- 
cyntli. The dried colocynth is inodorous, the white and spongy 
portion being very bitter and nauseous. From this spongy part 
alcohol separates a resinous matter called by Yauquelin, its dis- 
coverer, colocyntine. 

Colocynth has ever been regarded a drastic cathartic, and 
hence the comparative unfrequency of its exhibition. It is often 



COMPOUND POISONING. 377 

very violent in its action, causing inflammation of the bowels, 
bloody stools, and other bad effects. Hence it has been often 
resorted to for the purpose of inducing abortion; not that it has 
any direct emmenagogue power, but because of its severe irrita- 
tion of the rectum, which is transmitted to the adjacent uterus. 
On the same principle, it has been found a remedy for gonor- 
rhoea, and as such has been employed chiefly by sailors, dis- 
solved in whisky, which makes it more palatable than the watery 
solution. 

Such is the violence of the operation of this article, when 
taken by females to induce abortion, that it kills in a few hours, 
or sets up terrible colic pains, which recur frequently during 
life. A teaspoonful and a half of the powder of colocynth killed 
a woman in twenty-four hours by setting up incessant vomiting 
and purging. 

If the powder of colocynth be applied to a raw surface, as an 
ulcer, on any part of the body, it gives the same results in the 
lower bowels that follow its internal use. 

The ordinary dose of the pulp is from four to ten grains. In 
the smaller dose it seldom gripes or acts unpleasantly after a 
third or fourth trial. 

The oil of colocynth has lately been spoken of as an external 
remedy for neuralgia. (See Braithivaites Retrospect.) The 
extract is a good preparation alone, or joined to other articles. 
The dose is from one to three grains. 

The compound extract of colocynth is a good cathartic. It is 
made thus : — Take of colocynth pulp, §vi ; aloes, Sxij ; scam- 
mony, %iy ; cardamom-seed in powder, gi ; soap, giij ; proof 
spirit, one gallon. Macerate the colocynth in the spirit four 
days with a gentle heat, strain the solution and add it to the 
aloes, scammony, and soap ; evaporate, adding the cardamom 
near to the close of the process. The dose is from five to thirty 
grains. The celebrated Fothergill's pill contained this compound 
extract largely. 

Besides the use of very poor scammony, the extract is badly 
imitated by adding chalk and starch. The former is detected by 
muriatic acid, which causes an effervescence, muriate of lime be- 
ing formed. If the filtered decoction, slightly acidified, becomes 
blue or purple on adding the tincture of iodine, we infer the 
presence of starch. 

Compound Poisoning. — By the term compound poisoning we 
mean the effects induced in the system by the action of a mix- 
ture of two or more poisonous agents. When any two of these 
are so employed they may greatly modify each other, and the 
symptoms, effects, &c. may be very different from those usually 
produced by either alone. In fact, where poisoning is effected 

25 



378 COMPOUND POISONING. 

by design, it is not always possible to know how many articles 
may have been combined, and all investigation must of course be 
uncertain as to its result, and be greatly obscured. We have 
seen that tobacco passed into the stomach of a man who had 
swallowed a quantity of arsenic will in some way or other pre- 
vent the poisonous effects of the latter. And we know that 
tobacco thus passed into the same stomach in health would be 
productive of very unpleasant consequences of a peculiar kind, 
x et it has the property of neutralizing the arsenic, or at least of 
rendering it harmless. Suppose a man were to take a great dose 
of tobacco and arsenic at the same time, who can tell what the 
effect would be? And how can we know in many cases what 
mixtures are resorted to expressly to kill in the most effectual 
manner ? 

It is obvious, therefore, from these brief remarks, that a col- 
lection of cases of compound poisoning can amount to nothing 
more than so many isolated facts brought in contact, yet unex- 
plained, and perhaps inexplicable. As they are at all events in- 
teresting, it is proper to keep them faithfully recorded. We re- 
member the case of a man who for several days took poison in 
everything he ate, and was at last destroyed by violent purga- 
tion, caused by a compound poisonous injection. It would not 
be an easy task to assign to each poisonous ingredient employed 
in such a case its precise share in the mischievous and fatal 
issue. 

We learn from the Medico-Cliirurgical Review ', vol. vii., that 
arsenic and corrosive sublimate have been joined for the purpose 
of committing suicide, as though either had not sufficient energy. 
The quantity of each was fifty grains, and the dose caused a 
burning heat in the bowels very speedily. An emetic effected 
the evacuation of part of the poisonous mixture, but the man 
still suffered from severe pain and thirst. The emetic was re- 
peated, followed with mucilaginous drinks. This treatment 
brought on a diarrhoea of eight days' continuance. There was 
also considerable vomiting and convulsive twitchings. As in- 
flammation was present, means were adopted to subdue it. The 
man gradually got well. 

Had the same quantity of corrosive sublimate or arsenic as 
above named been taken singly, it would, for aught we know, 
have killed the man. What modification resulted from the union 
we do not pretend to know, and will not conjecture. 

Arsenic and nux vomica, both deadly poisons, have been 
combined and swallowed in large portions and yet the deluded 
experimenter has recovered. We learn from the British Annals 
of Medicine, vol. ii., that a female took two drachms of arsenic 
and a half-drachm of nux vomica at once. What man in his 



COMPOUND POISONING. 379 

senses would not shudder at the thought of taking one-half of 
either? An emetic of sulphate of zinc quickly vomited her, and 
the stomach-pump was also put in requisition to clean out the 
stomach. Lime-water and mucilaginous drinks were given freely ; 
and leeches to the pit of the stomach allayed the gastric inflam- 
mation, after which she got well rapidly, and was discharged 
cured on the sixteenth day. 

Arsenic has failed to kill when taken by a man under the 
usual effects of ardent spirits. It is supposed that the narcot- 
ism induced by the alcohol put the stomach in such a state as to 
prevent the common operation of arsenic. But when arsenic 
is taken after a night's debauch and the alcohol has not 
been repeated, the man, although apparently drunk, will hardly 
escape the poisoning influence of the arsenic. There will occur 
a state of indirect debility of the stomach which will give 
greater energy to the mineral poison. 

Arsenic with a moderate share of laudanum will not neces- 
sarily be a fatal mixture. In fact, recoveries have taken place 
after such doses have been swallowed. If there be just laudanum 
enough to narcotize, and free vomiting or the stomach-pump be 
employed, the chance of recovery is pretty good. A case is 
given in one of the volumes of the Edinburgh Medical and 
Surgical Journal, of a woman who swallowed two drachms of 
arsenic and three ounces of laudanum at the same time. In four 
hours after she had no burning in the throat, stomach or bowels, 
no abdominal tenderness, and little stupor. She took an emetic, 
which left her in a state of fatigue and inclined to sleep. The 
eyes were bloodshot and heavy, pupils contracted, pulse 100. 
Emetics, bleeding from the arms, leeches, blistering, and cold 
affusion were ordered, and she was kept in motion as much as 
was practicable. The drowsiness increased, and she became 
comatose, with pupils dilated, and breathing laboriously. She 
died in nine hours after taking the poison. In this case it is 
quite apparent that the power of the laudanum triumphed over 
the energy of the arsenic ; and although arsenic was found in 
the stomach, the other morbid appearances were such as often 
follow poisoning by laudanum. 

In the New York Journal of Medicine for October, 1840, 
Gordon Buck, M.D., has given an interesting case of compound 
poisoning in a very slight degree, caused by the accidental swal- 
lowing of thirty grains of opium and sixteen of acetate of lead. 
The close was taken at about eight o'clock on the night of 
January 26. At midnight, the patient felt unwell and vomited. 
He did not rest well for the remainder of#|}ie night; but no sign 
of narcotism ensued, and on the next day he was about as well 
as usual. 



380 COMPOUND POISONING. 

In the same article the doctor reports the case of a man who 
took a drachm of opium with a scruple of sugar of lead. In a 
half hour after an emetic was given, and no serious result fol- 
lowed. 

A case is given by Christison, on the authority of Mackin- 
tosh, showing the action of corrosive sublimate and laudanum 
combined. A young soldier swallowed two drachms of the 
former and half an ounce of the latter. The narcotism caused 
by the laudanum suspended for a little while the usual action of 
the mercurial poison ; but presently it developed itself in violent 
salivation, and bowel disease of an inflammatory character, and 
he sunk on the ninth day. The stomach and intestines were 
found enormously inflamed and ulcerated, with here and there 
gangrenous spots. I have no doubt that two or three ounces of 
laudanum would have prevented the mercurial action completely, 
and that the man would have died in an apoplectic state. 

The London Medical Giazette for April, 1841, has this case : 
A child five years old had swallowed a considerable quantity of 
u gun-barrel broivning" This is composed of corrosive sub- 
limate, sulphate of copper, and tincture of sesqui-chloride of 
iron. 

The child made ineffectual efforts to vomit, had severe epigas- 
tric pains, and the pulse was feeble and quick. Perfectly 
rational, although listless and heavy. Copious draughts of milk, 
with white of eggs, were freely given. These brought on vomit- 
ing, and relief soon followed. A gentle emetic of ipecacuanha, to 
remove the consequent torpor of the stomach, acted kindly, and 
perspiration, followed by quiet sleep, left him convalescent. 

In this case, says the reporter, very truly, the albumen acted 
as an antidote to the salts of copper and mercury. 

The case of the individual, who after swallowing seventeen 
grains of tartar emetic attempted to suffocate himself by means 
of the fumes of burning charcoal, is highly interesting. It 
illustrates forcibly the doctrine of counter-irritation, and sug- 
gests a very important hint in respect of its practical applica- 
tion. The carbonic acid and carbonic oxide gas evolved by the 
burning coal annoyed him sorely by their narcotic property ; but 
this more than countervailed the stimulus of the tartar emetic, 
for the latter scarcely excited nausea. 

Strange as it may seem, the various narcotics often counteract 
each other. A modification of this principle is noticed by the phy- 
sician, in the readiness with which he can substitute them for each 
other in the management of disease. Opium and belladonna 
have been employed in form of injection in considerable portions 
without inducing the common effects of either. This may depend, 



HEMLOCK. 381 

however, on the nature of the morbid action at the time, or on 
some peculiarity which is not to be detected. 

Where laudanum and brandy follow each other speedily, and 
in due proportions, the individual may survive. If, however, the 
proportion of laudanum be very great, its power will predominate, 
and death from narcotism will ensue. 

In short, as already intimated, we can decide nothing accu- 
rately, except the fact that death has resulted from poison, where 
deleterious substances have been combined and thus taken for 
suicidal purposes or given to perpetrate murder. We cannot 
possibly determine the relative quantity of each, nor can we al- 
ways ascertain how many poisonous articles have been conjoined. 
Of course the symptoms will fail to guide us with anything like 
certainty, for we may look for a blending of these to a greater 
or less extent in all cases of mixed poisoning. 

Conium Maculatum. Hemlock. — The leaves and seeds are 
the parts of this vegetable most usually employed in medical 
practice. The leaves are of a dark-green color, the upper sur- 
face being much darker than the under, and when rubbed between 
the fingers they emit a strong and peculiar odor. The ripe 
seeds are smooth and of a brown color. The plant flowers in 
June and July; and just before the time of flowering the 
leaves are in perfection, and should be gathered and slowly 
dried in a loft having a free current of air. It injures this and 
most plants to dry the leaves rapidly in a hot sun, or by artifi- 
cial heat, as some active volatile matters are thus driven off. 
When dried with care and kept in tight vessels the medicinal 
properties are retained a long while. 

The extract, which is more frequently employed than any 
other preparation, can be made either of the seeds or leaves, 
the latter being generally preferred. The most convenient mode 
of getting a good extract is by bruising the fresh leaves, collect- 
ing the juice and evaporating it to a proper consistence in 
the sun. The extract thus made will not keep as long as 
the alcoholic extracts made of the seeds, but it can be kept 
from one season to another, when a fresh quantity can be 
made. It is a more efficient medicine than the alcoholic pre- 
paration. 

Hemlock has always been favorably regarded as a narcotic, 
and therefore a proper substitute for opium, or a good article to 
combine with it. It is also well adapted to the use of opium- 
eaters who desire to be cured of a bad habit. The narcotic pro- 
perty is much modified by cultivation. In Greece, Italy, and 
Spain, it is at the maximum ; less energetic in England ; and null 
in Russia. So harmless is the fresh hemlock in the latter place 



382 HEMLOCK. 

that the peasants eat it as greens after boiling in several changes 
of water. 

The juice expressed from fresh hemlock leaves has been em- 
ployed as a remedy for itch. An Italian, Dr. Pelligrini, affirms 
that if the parts be coated with the juice daily for five or six 
days the disease will disappear. A solution of good extract 
will answer nearly as well. The juice and the extract have also 
been applied with happy effects to painful hemorrhoidal tumors, 
to irritable ulcers, cancerous sores, &c. A bread and milk 
poultice over which the fine powder of the dried leaf or extract 
is sprinkled will often serve the same purpose. 

The internal use of the leaves has not been so common as that 
of the extract, though both are sometimes combined, as their pro- 
perties are alike. An obvious advantage of this and some other 
narcotics over opium consists in the fact that they do not consti- 
pate the bowels, even in augmented closes. 

The combination of blue mass with the extract of hemlock 
unites a desirable soothing influence with a favorable alterative 
agency. I have employed this combination with the twofold in- 
tention named, in erysipelas that returned very frequently, 
affecting almost exclusively the face. By persisting in the use 
of pills containing a half-grain of the blue mass and one grain 
of the extract for a few weeks, I have succeeded in so chang- 
ing the diathesis as to lengthen the intervals of attack from 
three weeks to six months, and at last to effect complete re- 
covery. 

It is sometimes desirable to make a substitute for Dover's 
powder by adding the extract of hemlock in place of opium to 
the ipecacuanha and sulphate of potash. When this powder con- 
stipates, the substitute will be desirable. Five grains of the ex- 
tract may be added in place of one grain of opium. 

The proximate principle eoneia, or coneine, has all the virtues 
of the plant, but is not much employed. 

Many physicians emplo}^ the extract of hemlock and calomel 
as a last resort in chronic affections which they do not under- 
stand, in the hope of accomplishing some good, they know not 
how or why. In truth, it will rarely appear that hemlock alone 
is capable of doing much service, and hence it is almost always 
exhibited in combination. 

In very large quantities hemlock will certainly poison. The 
stomach-pump should at once be resorted to, or a prompt emetic, 
so as to evacuate the stomach completely. When this end is at- 
tained, $ome of the vegetable acids in a diluted state should be 
given to restore the lost tone of the stomach. Vinegar and 
water or weak lemon juice will answer very well. 

Contra-Stimulant. — This term has been applied to the action 



USES OF COPAIBA. 383 

of large doses of tartar emetic in the treatment of pneumonia 
according to the Italian practice. (See Antimonium.) 

Copaiba. — Sometimes, but erroneously, called balsam copaiba. 
There are several modes of spelling this word, but they are un- 
important. It is the liquid resin of the Copaifera officinalis, 
obtained by wounding the bark of the tree and so allowing exu- 
dation to ensue. It is brought to this country in small casks 
or barrels, or yet smaller vessels, some of which being made of 
copper have been supposed to give the copaiba a green tinge, 
which is a mistake. The article comes for the most part from 
the Brazils. 

The consistency of copaiba varies with season, being some- 
times quite thick and viscid, and then very thin and easily poured 
from vessel to vessel. It varies in point of color, being some- 
times quite pale, or slightly yellow or greenish. It has a pecu- 
liar odor, which to most persons is exceedingly disagreeable, and 
constitutes a strong objection to its use as a medicine. The 
smell, unfortunately, is not evanescent, but often permanent. 
The taste is quite pungent, and a slight degree of nausea attends 
its administration not unfrequently. It is not soluble in water, 
yet imparts its flavor to that fluid so much as to remain for a 
considerable time. It is soluble in ether and in alcohol, and is 
lighter than water. 

The pure or unmixed copaiba can be taken on loaf-sugar, or 
in emulsion made of yolk of egg or gum Arabic. Aromatics, as 
cinnamon-water, lessen its nauseous quality and make it tolerable. 
Thus :— 

R. — Copaiba, half a drachm ; 

Powder of gum Arabic, 

And sugar, each a drachm ; 

Cinnamon- water, an ounce. 
Mis. 

The whole of this may be taken by an adult at once, or from 
twenty to forty drops may be added to white sugar as a substi- 
tute. If these doses be continued or increased there will be 
purging and increase of urine, and if it fail to do either it may 
act merely as an expectorant. The cathartic and diuretic effects 
are more constant. 

Copaiba has been extolled as a remedy for irritable conditions 
of the bladder, for gonorrhoea, for gleets, for fluor albus, for 
chronic coughs, piles, &c. &c. Some physicians have employed 
it in the shape of injection, especially for the cure of gleets, and 
have thus obviated or greatly lessened the unpleasant odor of the 
article. From two drachms to a half-ounce should be thrown up 
the rectum at once, and repeated as occasion may require. Del- 
pech prescribed copaiba in a novel form in his treatment of gonor- 



384 SOLIDIFIED COPAIBA. 

rhoea, declaring that the prescription was remarkably successful. 
Thus :— 

R. — Mint water, 

Orange-flower water, 
Lemon syrup, 
Copaiba, each, ^i; 
Sulphuric acid, gij ; 
Mucilage of gum Arabic, q. s. 
To make a good mixture. The dose was a tablespoonful night and morning. 

If the medicine purged the patient, from ten to fifteen drops 
of laudanum were added to each dose. 

Dr. Dover gave tablespoonful doses of copaiba to aid the pass- 
age of a stone to the bladder. (See his Physician s Legacy ^ 
p. 56.) 

Dr. Reverdy employed copaiba in the management of pulmo- 
nary catarrh. He thought the efficacy of the medicine did not 
depend on its cathartic power, but rather on its expectorant 
action. From forty to sixty drops were given for a dose, and 
repeated every three hours. Dr. La Roche published some facts 
to the same point in the North American Medical and Surgical 
Journal, formerly issued in this city. 

The attending physician of the Philadelphia Orphan Asylum 
reported favorably of copaiba as a remedy for chilblains. After 
washing the parts well at bedtime with warm soapsuds, the 
copaiba was freely applied, and the operation repeated for a 
week. (See American Journal of Medical Sciences for 1838, 
p. 504.) 

The late Dr. Hewson, of Philadelphia, noticed a peculiar 
eruption, somewhat like measles or smallpox, induced by the 
continued use of copaiba. (See North American Medical and 
Surg. Journ.) And other physicians in this country have noticed 
the same thing. Raleigh gives an account of the same accident, 
in the India Journal of Medicine for 1834. Dr. Dickson speaks 
of it in his work on the Unity of Disease, and Professor Sig- 
mond notices it in the London Lancet. The eruption is some- 
times very limited, but occasionally covers the body, and disap- 
pears without desquamation at the end of four or five days. I 
have never witnessed this result, because I have not been in the 
habit of prescribing the copaiba. 

The solidified copaiba, or inspissated copaiba made by Car- 
penter, is preferred by some practitioners to the liquid article. 
An imitation can be made by triturating calcined magnesia with 
copaiba till it will take up no more. The copaiba capsules are much 
more in favor with many persons who have occasion to use the 
medicine. An alakaline mixture, combining potash with copaiba, 
has also been employed. But I doubt, as a general rule, whether 
the pure article, per se, is not the best form of administration. 



COPALCHI BARK — DOGWOOD. 385 

One of the oldest compounds for the cure of venereal disease, 
and known by the title of Jesuit's drops, is thus made : — 

R. — Copaiba, ^vi; 

Gum guaiac. ^iss ; 
Laur. sassaf. ^iij ; 
Carb. potass, ^iij ; 
Alcohol, ftriv. 
Digest in a sand-bath for three or four days, and filter. 

Many years ago guaiacum was held to be a powerful anti- 
venereal medicine, and joined to copaiba it made a mixture that 
once ranked as a panacea. 

The large quantity of copaiba in this mixture proves conclu- 
sively that its powers were highly estimated, and there are many 
practitioners now who think it an exceedingly valuable medicine 
in the treatment of gonorrhoea. 

Copalchi Bark. — This is the name of a bark said to be much 
employed by the Mexican and Peruvian physicians in the treat- 
ment of intermittents, and as a warm, aromatic, bitter tonic, well 
suited to many cases of dyspepsia. From all that I can discover 
in the history presented, this article differs very little from casca- 
rilla in its medicinal properties. It is probably furnished by the 
Croton-pseudo- China, of Schiede, but does not appear to be of 
sufficient importance to call for more extended notice. 

Coriandrum Sativum. Coriander. — The seeds have long 
been in use in the East as a condiment, being an ingredient in 
the famous Currie powder. Confectioners and distillers employ 
the seeds in large quantities. The seed has a peculiar odor, a 
warm aromatic taste, which is due to a yellowish volatile oil. The 
seeds and oil are stimulant and carminative, and are chiefly em- 
ployed as an adjunct to various preparations, as the confection of 
senna, infusion of senna with tamarinds, compound tincture of 
senna, &c. &c. 

From half a scruple to a drachm of the seeds may be taken 
for a dose, and from three to five drops of the oil. 

Coptis Trifoliata. Gfolden Thread. — An indigenous, ranun- 
culaceous plant, the powdered root of which has long been known 
to the peasantry as a simple bitter tonic and astringent. The 
botanical and steam-doctors fancied that it possessed other pro- 
perties. The dose is from ten to thirty grains in a little simple 
syrup. The root abounds with filaments of a bright yellow, and 
hence its common name. The Shakers deal in it largely. 

Cornus — circinata, florida, sericea. Dogwood. — The dogwood 
tree is to be seen in almost every part of the United States, and 
all the varieties agree in medicinal properties, having been em- 
ployed from time immemorial as substitutes for the bark, for the 
cure of ague and fever. Dogwood is, therefore, to be regarded 



386 USES OF COTTON. 

as tonic and antiperiodic. The bark and the flowers are the 
parts of the tree most in use, and are given in powder, decoc- 
tion, and extract. Tannin, extractive, gallic acid, and resin are 
contained in it, and hence it is obvious that astringent powers 
reside in it. 

The dose of the bark or flowers in powder is from twenty to 
fifty grains, frequently repeated. The infusion or decoction 
may be made as strong as it can be, and drank ad libitum. An 
ounce added to a pint of boiling water is the ordinary pro- 
portion, and the addition of a half-ounce of Virginia snake-root 
renders the mixture more agreeable and effective. Oornine is 
the proximate principle. 

Corrosive Sublimate. (See Hydrargyrum.) 

Cotton. Grossypium Herbaceum. — I am aware that this is 
not often regarded as an article of Materia Meclica, yet it merits 
a place here. So far as I can learn, its earliest medicinal use 
was as a mechanical means to arrest hemorrhage. Subsequently 
it was applied to burnt or scalded surfaces with great advan- 
tage. The finest carded cotton should be selected for burns and 
scalds. It affords prompt relief, and if applied early prevents 
vesication. It is also an excellent application to severe bruises 
or contusions, especially in persons of irritable habits, whose 
flesh heals slowly. For this end I know of no means more salu- 
tary and agreeable. 

But a more recent use is in the treatment of erysipelas, which, 
indeed, approximates closely to the nature of burns and scalds. 
It is probable the success -of cotton in the latter led to its use in 
the former. 

M. Regnault, a writer in a French journal, affirms that cotton 
calms the pain and burning and itching of erysipelas as by a 
charm. He says it soon evolves a gentle, pleasant moisture, 
which continues, and with the effect, too, of relieving all the local 
uneasiness. The swelling gradually vanishes, as well as the red- 
ness. The skin becomes flaccid and wrinkled, showing none of 
the furfuraceous scales that mark the disease as usually treated. 
The general excitement ceases, fever subsides, and the organic 
functions resume their salutary state, frequently without other 
treatment. Kegnault employs the cotton in every location. He 
thinks it establishes a kind of mild vapor-bath on the part, keep- 
ing up uniform temperature and moisture. In this way it often 
cures by re-solution, avoiding vesication altogether. He applies 
the finest and cleanest cotton, so as to exclude air and light but 
not so as to be oppressive. The cotton should extend two inches 
beyond the inflamed spot, and have a very light compress to con- 
fine it. If the face be attacked, a linen mask is employed to 
keep the cotton in place, and it is needful to remove the whole 



COTYLEDON UMBILICUS. 387 

once in twent y-four hours to watch the effect. Should the cotton 
adhere to the skin, it must be detached with a soft poultice. The 
remedy is of easy application, but cannot supersede the use of 
proper means to correct the general system, such as emetics, 
emeto-cathartics, low diet, &c. Many years ago, Dr. Merrill, of 
Natchez, recommended carded cotton as the best application to 
blistered surfaces. He found that when it was not desired to 
keep the blistered spot open and running, but rather to heal it 
promptly, the cotton was the best sort of dressing. He laid it on 
a half-inch thick, extending an inch over the edges of the blistered 
part. In two days, ordinarily, a new cuticle was formed, and 
the spot healed over. The dressing gives no pain, and is quite 
easily managed. The account furnished by Dr. Merrill may be 
seen in the North American Medical and Surgical Journal, 
published more than twenty-five years ago; and yet the same 
practice has been announced as original by a Dr. Maclaglan, in 
a foreign journal, within the last ten years. 

It remains to notice an internal use of the cotton plant that 
is peculiar to the far South, where it grows abundantly. Drs. 
McGown, Bouchelle, and others, employ the bark of the root as 
a parturient medicine in the form of decoction. Four ounces 
are boiled, in a quart of water, to a pint, the dose of which is one 
or two ounces every ten or fifteen minutes. It is affirmed to be 
safer than ergot, and equally efficient. 

Cotyledon Umbilicus. — So far as I can learn from the state- 
ment of Mr. Satter, in the London Medical Gazette, March, 
1849, this plant belongs to the house-leek family, and is kindred 
to sedum and sempervivum. The sedum acre is spoken of as 
having been employed by the Germans in the same disease for 
which Mr. S. recommends the cotyledon umbilicus, viz., epi- 
lepsy. The statements of Mr. S. are fully confirmed by those 
of Mr. Bullar, surgeon at Southampton. 

Two teaspoonfuls of the expressed juice were given three 
times a day, and continued for several months, with the effect of 
putting an end to the epileptic seizures. In some instances, the 
recoveries were complete ; in others, very manifest improvement 
followed. One of the cases had been variously treated for twelve 
years, and finally yielded to this article alone. 

We have no personal knowledge of this remedy, and presume 
that the common house-leek may possess all the advantages of 
the cotyledon. It is highly commended in part nineteen of 
JBraithwaite's Retrospect, to which the reader is referred. 

Counter-irritant. — This refers to the setting up of a new 
action in the neighborhood of a diseased spot with the view of 
transferring it from its original seat, as in the use of blisters for 
the relief of pleurisy. 



388 COUNTER-POISON — CREOSOTE. 

Counter-poison. This term seems to carry with it the proper 
explanation. It occurs whenever two acknowledged poisons 
meet in the stomach and do comparatively little harm, evincing 
no morbid phenomena such as either, acting alone, would de- 
velop. Christison gives cases in point in his excellent work on 
poisons. A man may not be seriously injured by swallowing a 
large quantity of corrosive sublimate and, shortly after, an over- 
dose of laudanum, though each, by itself, would be sufficient .to 
kill. It would seem that the two poisons form a sort of tertium 
quid, or neutralize each other so as to be almost harmless. (See 
Compound Poisoning. 

Cowhage. (See Dolichos Pruriens.) 

Crabs' Claws. (See Calx.) 

Creosote. Creasote. Kreosote. — The name indicates the 
prominent quality of the article. It is of Greek derivation, 
meaning preservative, and hence its antiseptic power. Riechen- 
back, a German chemist, discovered it not many years ago, when 
experimenting with tar. He found this article to contain, in 
addition to creosote, paraffine, picamar, capnomor, pittacal, &c. 
&c. All these are compounded of carbon, oxygen, and hydrogen. 

Creosote is an oily-looking fluid, and when quite pure is color- 
less and transparent. Now and then it has a yellow or brown 
tinge, which does not lessen its value materially. The peculiar 
smell of the article seems like a concentration of the odor of 
wood-smoke, or the vapors of pyroligneous acid. All these act 
alike in the preservation of animal substances for domestic and 
scientific purposes, imparting the same color and odor. Creosote 
has a burning taste, followed by a sense of sweetness. Dropped 
on paper it leaves stains, which soon vanish. There is a pecu- 
liarity in creosote in respect of its power to unite with water, 
with which it combines only in certain proportions, as 1 to 100 
or as 10 to 100. Alcohol, ether, carburet of sulphur, and acetic 
acid combine with it in all proportions. It is wholly void of 
acid and alkaline qualities, yet combines with acids and alkalies. 

One of the most important properties of creosote is its power 
to coagulate albumen, as on this depends its antiseptic character. 
Muscular fibre, apart from albumen, is incapable of the putre- 
factive process, and the albumen being coagulated and hardened 
resists putrefaction. Smoke and pyroligneous acid act on the 
same principle. 

Solution of creosote has been employed for the preservation of 
anatomical preparations. One part of creosote to 400 of water 
answered the purpose. Birds poisoned with creosote have been 
found to resist putrefaction, and animals can be perfectly mum- 
mified with it, so as to keep for an indefinite length of time. 
Mere immersion in the creosote solution, or injection of it into 



THERAPEUTIC POWERS OF CREOSOTE. 389 

the vessels, will suffice. Cormac affirms that lie kept the lungs 
of a dog in good order more than three months after killing the 
animal with creosote. From all the known facts, it has been in- 
ferred that the Egyptians employed something containing creo- 
sote in their process of embalming. 

The action of an overdose of creosote on man is very severe, 
and there is no antidote for it. It sets up violent gastric pains, 
extending to the pharynx, with acute pain of the tongue and 
lips. After the pain subsides a little there remains a very dis- 
agreeable taste in the mouth. This latter is quite perceptible 
after employing the creosote for toothache. Injected into the 
veins, it arrests the heart's action instantly. Large doses cause 
speedy death, with extensive organic lesion, and particularly 
gastro-enteric inflammation. In smaller doses, it has induced 
torpor of sensation and motion, especially of the lower extremi- 
ties, the heart, and diaphragm. Mixture with oil and mucilage 
very much reduces its power, but vinegar increases its poisonous 
action. Applied to the sound skin, it acts as a powerful irritant, 
inducing inflammation and ulceration. Laid on an inflamed part, 
it proves a counter-irritant, and abates the inflammatory action. 
Its styptic qualities have been proved by its power over hemor- 
rhages. It is stated in the Edinburgh Medical and Surgical 
Journal for October, 1841, that a sponge soaked in creosote 
speedily arrested the bleeding consequent upon the operation for 
lithotomy. 

Cormac and Elliotson have written very fully on the medical 
uses of creosote, but its real therapeutic characters are not fully 
ascertained. It may be stimulant, sedative, narcotic, irritant, 
counter-irritant, poisonous, and antiseptic, according to circum- 
stances, as all these properties have been developed frequently. 
Like every new article of great power, it was made a hobby, a 
veritable panacea; yet it certainly deserves our attention. 

One of the earliest uses of creosote was for the cure of tooth- 
ache. The common practice was to put a drop of the article on 
a very small quantity of cotton, which was then to be placed in 
the cavity of the tooth. The remedy acted by paralyzing the 
nerve and by correcting the fetor of the tooth ; and in many in- 
stances was promptly beneficial. In this use of it, however, care 
is required, so as to avoid too large a dose, and to guard the face 
from its local irritation. 

In a great variety of cutaneous affections, as, for instance, 
erysipelas, tinea capitis, almost every grade of chronic and recent 
tetter, burns, and scalds, ill-conditioned ulcers of the surface 
and throat, naivi materni, chilblains, &c, it has been frequently 
successful. It has also been employed to arrest profuse saliva- 
tion. As these are properly instances of the external use of the 



390 CREOSOTE IN SKIN DISEASES. 

creosote, we shall attend to them briefly before we speak of the 
internal administration. 

Dr. Eahnestock, of Pennsylvania, has reported favorably, in 
the American Journal of Medical Sciences for July, 1848, of 
the use of creosote in erysipelas. He applied the pure, unmixed 
article, with a hair pencil, over the inflamed parts and a little 
way on the sound skin. The whole of the inflamed surface very 
soon became nearly white, showing a decided action. The bowels 
were kept free at the same time by doses of calomel and jalap. 
The same treatment precisely has been successful in France in 
the most obstinate tinea capitis, and I think it merits attention. 
The merely local treatment, however, would avail nothing, unless 
the general system received due regard. 

Dr. Elliotson treated a case of tetter of seven years' standing 
with this medicine. He gave two drops three times a day, 
gradually increasiug to twenty drops, beyond which he could not 
go, because of giddiness and tremors of the whole frame that 
supervened. The patient recovered. A still more remarkable 
case is given by Professor Wolf, of Berlin, who had a patient 
laboring under scaly tetter for twenty-five years cured by the 
internal and external use of the creosote combined. 

Burns and scalds have been very frequently treated with 
creosote with the happiest results. Berthollet, Biechenback, 
Coupil, and others, bear testimony to its value in these relations. 
A striking advantage claimed for it is that it always gives rise to 
regular cicatrices, avoiding contractions and disfigurations. The 
first effect is to form a crust over the burnt or scalded part ; this 
soon separates, and generally, too, without suppuration, The 
ivater of creosote is commonly employed for these ends, and is 
made by adding three or four drops to an ounce of water, or a 
drop to a hundred drops of water. Ulcers of the skin, or fauces, 
tonsils, &c, have been greatly improved by gargles of creosote 
water. These not only correct the fetid emanations from the 
ulcers, but stimulate to more healthful action. In some old 
phagedenic ulcers, Dr. Shortt, of Edinburgh, has found an acetic 
solution to be more efficacious. He adds ten drops of creosote 
and two drachms of acetic acid to two ounces of water, and 
applies this to the entire surface of the ulcer, with a fine hair 
pencil, two or three times a day. Chancres were treated thus 
with obvious advantage. 

Ncevi materni, or small red tumors found at birth on various 
parts of the body, and particularly on the head and face, have 
been recently cured by the use of creosote, applied two or three 
times a day, sometimes diluted, and occasionally unmixed. Ex- 
coriation is speedily excited, and the absorbents are stimulated 
to unwonted action, so as to remove the body in a few days. 



ANTI-EMETIC POWERS OF CREOSOTE. 391 

Dr. Hahn, of Stuttgart, managed chilblains with creosote 
water and creosote ointment. Equal parts of creosote and 
almond oil well mixed made the ointment or cerate, which was 
applied to the parts, after having been rubbed with a smooth 
cork. Once a day the creosote water was applied. A few days 
sufficed for cure. 

The last external use to be named is for the arrest of profuse 
salivation. Merely painting the gums with creosote water has 
answered for this end, the astringent and styptic power being 
promptly manifest. 

It is stated, also, by a writer in the Philadelphia Medical Ex- 
aminer, that a gargle composed of half a drachm of creosote 
and a pint of sage tea promptly checks mercurial salivation 
when the ordinary remedies prove unavailing. It must be em- 
ployed frequently through the day. 

The internal uses of creosote are numerous, and the dose 
somewhat variant and dependent a little on the purity of the 
medicine. The average adult dose is one drop, but it may be 
augmented gradually to ten or even twenty with benefit. In 
very delicate females a half-drop may be quite enough for a first 
dose. 

The anti-emetic powers of creosote are very important. We 
are often perplexed to know what to do with a very irritable 
stomach. We give this and that to no good purpose, and forget 
that creosote is often the very medicine for the case, although 
truth compels us to^say that it has failed. Elliotson has lauded 
it very highly for the arrest of vomiting, and no doubt justly. 
Sometimes a half-drop will suffice, added to a tablespoonful of 
water ; or a drop or even two drops may be necessary. If the 
first dose is rejected, repeat in a few minutes, and it will probably 
remain. If that be thrown up, wait ten minutes, and try it again. 
If this be retained, give another dose at the end of an hour. 
This will often suffice. 

In the vomiting that attends colic and enteritis, creosote has 
had the effect of calming the stomach long before the cathartics 
exhibited were able to effect an evacuation of the bowels. 

Bloody vomiting has been almost immediately checked by a 
half-drop, given in mucilage of gum Arabic and repeated every 
half hour until four doses were taken. (See London Lancet, 
May, 1841.) My son, Dr. Benjamin Rush Mitchell, of the U. S. 
Navy, employed creosote with success in the yellow fever of Sal- 
madina Island, in the Gulf of Mexico, during the late war, chiefly 
to control the terribly irritable condition of the stomach. (See 
Medical Examiner of Philadelphia, July, 1848.) 

A practitioner in the far West assured me that one of the 
most obstinate, unyielding cases of diarrhoea he ever saw was 



392 ANTI-EMETIC POWEKS OF CREOSOTE. 

promptly arrested by throwing into the rectum an injection of 
thirty drops of creosote in a few ounces of thin starch. This 
was a tremendous dose, and yet it spent its force no doubt on 
the morbid state of the intestinal mucous membrane almost ex- 
clusively. 

A paper in the Lond. Med. G-azette for February 7, 1857, 
speaks in terms of decided praise of the good effects of creosote 
in diarrhoea. The adult prescription was thus : — 

R. — Creosot. one to five drops; 

Spt. amnion, fifteen to sixty drops ; 
Aquae, ^i to ^iss; 

varied according to urgency of the case, adding, if the painjbe 
severe, a tablespoonful of paregoric elixir. Rarely has it been 
necessary to give more than two doses. More than a hundred 
cases were so treated successfully by Mr. Kesterven, the reporter. 
Mr. Spinks, of Warrington, reports very decided success in 
the treatment of Asiatic cholera with creosote. In one hundred 
and one patients treated with this medicine, the diarrhoea ceased 
promptly. In eighteen patients who had vomiting, rice-water 
discharges, cramps, and blue skin, it succeeded in all but two. 
The pulse became full and soft, a free perspiration breaking out 
over the surface and all the bad symptoms subsiding. The 
formula generally employed was as follows : — . 

R. — Creosote, twenty-four drops; 
Muc. g. Arab. J ss ; 
Spt. ammon. aromat. 
Spt. camphor, a a ^ij ; 
A quae, t ^viss. 
Mix. Take two large tablespoonfuls every hour. (See Braithwaite, partxx.) 

Dr. Dick, of Glasgow, treats gonorrhoea and gleet with creosote 
in preference to copaiba. He administers it in two-drop doses 
made into pills with loaf sugar or syrup. 

Professor Berndt, of Germany, and Dr. Elliotson, of London, 
report successful management of diabetes mellitus with creosote. 
Elliotson gave an emetic in the first instance, and then admi- 
nistered eight drops of creosote in pill form in the course of a 
day, gradually increasing to twenty-four drops. The dose was 
once carried to forty drops in a day. The facts are important, 
but we could not hope to cure the disease very often by this 
remedy. The styptic power of the medicine might be beneficial, 
but then it is needful to keep in mind the nutrition of the system, 
and by a proper diet to control the quality of the blood. This 
is often indispensable. 

Mr. Whitwell, of St. Marylebone Infirmary, reports several 
cases of purpura hemorrhagica successfully treated with creosote, 



CEEOSOTE IN NEURALGIA. 393 

and he infers thence its adaptation to scurvy. He employed it 
internally, and as a gargle and wash. Thus : — 

J£. — Creosot. gtt. ss ; 

Muc. g. Arab, ijiss ; 

Alcohol, q. s. to suspend the creosote. 
Take this every six hours. 

Jt. — Creosot. £ss; 

Aquse, ^xij ; 

Alcohol, q. s. to suspend the creosote. 
To be used often as a gargle and wash. 

The internal dose of creosote was gradually increased to a 
drop. (See London Lancet, February, 1843.) 

Mr. Kelly, an Irish surgeon, has treated facial neuralgia very 
successfully with creosote, as we learn from the Dublin Medical 
Press for September, 1847. The lady for whom he prescribed 
had been afflicted for many years, and was under treatment fre- 
quently, with little or no benefit. He directed three grains of 
creosote to be mixed with soft bread and divided into three pills, 
to be taken at the interval of an hour. At the end of six hours 
her distress had totally ceased, and she was astonishingly 
relieved. On the next day an ounce of castor oil was adminis- 
tered, and on the day following the creosote pills as before. At 
the end of a year there was no return of the disease, although 
previously the paroxysms had been very frequent and severe. 

In the London Lancet for December, 1842, Dr. Allnatt re- 
cords his experience in the use of creosote injections in the 
management of leucorrhoea. His formula is thus : — 

R. — Creosot. gtt. xx; 

Solut. potass, gij ; 

Sacch. alb. gij ; 

Rub together, and add aquae, ^viij; 
Mix, and use as an injection three times a day. 

In three or four days an old leucorrhoea has been arrested by 
this medicine. 

Inhalations of creosote have been happily used in phthisis and 
bronchitis by Dr. Thomas Inman, of Liverpool. The mode of 
using the remedy is very simple. From four to ten drops of 
creosote are put in the bottom of an old tea-pot and a little 
boiling water added. The spout is to be protected by a piece of 
flannel, and the steam is inhaled through it until it begins to feel 
cool. Care must be taken not to put more than an ounce or two 
of water in the pot. The immediate effects are a feeling of 
warmth in the throat and a sensation "as if you had lungs under 
your ribs," followed by reduced irritability of the mucous mem- 
brane, and the greatly improved condition of the countenance. — 
Med. Times and Gazette, May, 1853. 

26 



394 CROTON OIL. 

Very few cases of poisoning by creosote have been reported, 
and as yet no certain antidote is known. The following case 
was first published in the Liverpool Mercury of June, 1839, and 
is worthy of notice. A lady aged sixty-seven, in good circum- 
stances, had been prescribed for by her physician, who advised 
her usual dose, but told her not to take it unless compelled by 
the pain. At four o'clock next morning he was sent for, and 
on entering the lady's apartment heard her exclaim, "My God, 
I am poisoned ! That man has not sent the draught you pre- 
scribed. I have felt all on fire since I took it." The lady 
complained of agonizing pains, and although all proper efforts 
were made to relieve her she died in about thirty-six hours. It 
appeared, on inquiry, that in place of two drachms of spirit of 
camphor, as directed, the apothecary had added the same quantity 
of creosote, and the mixture was so strong as to blister the hand 
of a female who incautiously came in contact with it. 

As soon as possible after a large dose of this article has been 
swallowed it should be dislodged from the stomach by a mild 
emetic or by the stomach-pump. Diluents, mucilaginous drinks, 
and opiates should be given, and blisters applied to the epigastric 
region. To relieve suffocation it may be necessary to resort to 
artificial respiration.* 

Croton Oil. Qroton Tiglium. — The plant is a native of 
Ceylon and other eastern countries, and belongs to the natural 
order eupJwrhiacece, which yields the drastic spurge. The root, 
wood, leaves, seeds, all possess decided cathartic powers. In 
Eatavia the root was employed centuries ago as a hydragogue 
cathartic in the treatment of dropsy. In some parts of the East 
a decoction or infusion of the wood is esteemed a panacea. 

The oil was introduced into Europe in 1630 as a cathartic, 
and in 1632 it was exhibited in dropsy, A single drop of the 
pure oil added to a glass of Canary wine constituted a noted 
purgative for a long time before the medicine came to be gene- 
rally known. In Huf eland" s Journal it was proposed to form 
a substitute for castor oil by mixing a drop of croton oil with an 
ounce of almond oil. 

Croton oil has been a subject of adulteration. Occasionally, 
the price of the article has been very high, and then a tempta- 
tion presented for making as much as practicable out of a little, 

* Black urine, as a sequel of the administration of creosote, has excited con- 
siderable interest in the profession recently. Dr. Hughes, in Guy's Hospital 
Reports, 3d series, vol. ii., has named seven undoubted instances of a brown or 
purplish-black color so induced. In three cases, five, twelve, and fifteen drops 
had been taken in a day ; in another, only one drop four times a day. In one 
case the urine had the natural appearance when passed, but heat and nitric acid 
threw down a black precipitate, which, on exposure, became an indigo-blue de- 
posit. 



CROTON OIL. 395 

by the addition of castor oil and sweet oil. We can reconcile 
with truth the stories told of ten drops given to children with 
impunity only on the ground of extensive adulteration. Such 
a case was reported to me some years ago by a physician of the 
West. 

Eleven hundred and four ounces of the oil were rejected by 
the U. S. examiner of drugs for New York, in March, 1849, 
being largely adulterated with fatty matters. No wonder that 
physicians have been so often disappointed in the external as 
well as the internal uses of this medicine. 

The drastic action of croton oil is familiar to all who have 
employed it alone. A single drop laid on the tongue will act 
thus, and two or three drops rubbed on the umbilical region will 
purge smartly. From half a drop to a drop will purge a person 
who has been accustomed to it with almost no griping pain or 
other inconvenience. But larger doses, as two or three drops, 
act with violence. It is best administered made into pill with a 
little soft bread, the bulk being as minute as the manipulation 
will allow. 

The hydragogue effect is seen chiefly when it is administered 
for the relief of dropsy, or in cases of long-continued costiveness. 
The dose being repeated there is an accumulation of the article, 
and the mucous membrane is stimulated to profuse secretion. 
Should it act with too great violence a drop or two of some 
aromatic oil should be given, and repeated if need be in a half 
hour. The action on the bowels has been so severe occasionally 
as to induce temporary blindness. 

In various nervous affections marked by torpor, insensibility, 
contracted pupils, and a scarcely-perceptible pulse, croton oil is 
often usefully employed to rouse, by its stimulant action on the 
bowels, and so divert morbid action from the brain. The follow- 
ing formula is a good one : — 

&. — Croton oil, eight drops ; 
Castor oil, three ounces ; 
Mucilage of gum Arabic, one ounce. 

Mix well, and add to a quart of gruel; to be used as an injection. 

This quantity is administered in two parts, with an interval of 
an hour. The patient is roused by the action induced in the 
alimentary canal, and the result is actually due to counter-irrita- 
tion. (See Edinburgh Medical and Surgical Journal for July, 
1841.) The same kind of action has also been salutary in tetanus, 
and calls for repetition. 

An emmenagogue power has been ascribed to croton oil by 
Dr. Daly, of Madras, which was evidently the effect of high irri- 
tation of the lower bowels, and the consequent excitement of the 



396 USES OF CROTON OIL. 

uterine organs. There were fifteen females in an asylum, labor- 
ing under catemenial obstructions, to whom a strong infusion of 
the seeds of the croton tiglium was administered with complete 
success. Active purgation was doubtless set up, and hence the 
effect. The strength of the infusion is not stated. 

Dr. Macgregor regards croton oil as far better than calomel 
for congestion of the liver and jaundice. He usually combined 
tartar emetic and opium with the oil, thus : — 

R. — Croton oil, five drops ; 
Opium, 
Tartar emetic, each three grains. 

Mix, and divide into two pills ; to be given, with the interval of half an hour, 
in two doses. 

In jaundice he gave six grains of tartar emetic, three grains 
of opium, and five drops of croton oil, made into two pills with 
crumb of bread. He affirms that the compound rarely nauseates 
or vomits, but acts as a sedative cathartic. (See Medico- Chirur- 
gical Review, April, 1846, p. 373.) 

Dr. George Fife, Physician to Queen's Hospital, and Professor 
of Clinical Medicine and Materia Medica in Queen's College, has 
furnished an interesting paper in the London Lancet for July, 
1857, to show the efficacy of croton oil in dropsy dependent on 
hepatic obstructions. He employs it in drop doses, and assures 
us that although a drastic, it is not a hydragogue cathartic, as 
usually represented. He says that an ounce of Epsom salts will 
give rise to more watery evacuations than three drops of croton 
oil, and that the oil at once diminishes the quantity of fluid and 
exalts the power of the absorbents. He further declares that 
his patients took the oil with perfect impunity and with the most 
salutary results. Hence his conclusion that it is the most effec- 
tive and the safest medicine for the kind of dropsy referred to. 
He has employed the remedy over thirteen years and in a very 
large number of cases. 

In the bilious remitting fevers of India, Dr. Macgregor gave 
five drops of croton oil with three grains of opium, as a sedative 
cathartic. He supposed that by this means he completely 
emptied the overloaded gall-bladder, making the stools decidedly 
bilious. He says he lost but one out of three hundred patients 
treated in this way. He usually bled in the onset, then gave an 
emetic, and next the sedative cathartic. (See London Lancet, 
June, 1845.) 

The same physician speaks well of croton oil in the treatment 
of Asiatic cholera. He says it has seldom failed when given very 
early and combined with opium. He prefers bleeding ; but if 



USES OF CROTON OIL. 397 

no blood can be drawn, then he gives the following draught im- 
mediately : — 

R. — 01. croton tig. gtt. v; 

Tinct. hyosciam. gi ; 

P. opii, grs. v. 
Mix. 

If the spasms remain and free vomiting does not succeed, the 
following pills are administered until the skin becomes warm and 
the symptoms improve : — 

R.— Opii, grs. iij ; 

01. croton, gtt. v. 
Mix. To make a pill. 

Nine grains of opium and fifteen drops of the oil, in repeated 
doses, will produce the desired effect generally, though sometimes 
double the quantity was requisite. To prevent a relapse, sul- 
phate of quinine was given. — Quarterly Medical and Surgical 
Journal. 

Dr. Tegart employed large doses of croton oil in the remitting 
fevers of the West Indies about twenty years ago, as we learn 
from the Medico-Chirurgical Review for April, 1846. "Very 
large doses have also been employed successfully in the treat- 
ment of dysentery, in which it is said to have acted by unloading 
the congested gall-bladder and pouring bile copiously into the 
bowels. — Medico-Chirurgical Revieiv, Oct. 1845. 

The treatment of sciatica or sciatic neuralgia with croton oil, 
internally administered, is practically illustrated in the detail of 
cases successfully managed by Henry Hancok, Esq., as we read 
in the London Lancet for March 4, 1854. Mr. Hancok sup- 
posed the disease depended on mechanical irritation of the nerves 
within the pelvis, induced by a loaded colon or coecum. To meet 
this state of things the following prescription was made for a 
lady who had labored under the disease almost two years : — 

R. — 01. croton, one drop ; 
Pill mass. hydr. 
Ext. hyosciam. aa grs. iv ; 
Ext. colocyn. c. grs. viij. 
Misce et divide in pill iv. Take two at bedtime. 

The lady had been taking morphia freely, but was instructed 
to lay it aside gradually, and also to abstain from solid food. 
After the action and effects of the dose had subsided, three grains 
of sulphate of quinine were ordered to be taken every four hours. 
Recovery took place rapidly. Several other cases are given, 
treated in like manner with like result. — BraitJiwaite, part xxix. 
p. 72. 

The external uses have had reference mainly to high counter- 



398 POISONING BY CROTON OIL. 

irritation, pustulation, &c. Sometimes the oil alone has been 
resorted to for this object, but more frequently a mixture has 
been employed consisting of an ounce of sweet oil, two drachms 
of croton oil, and two scruples of tartar emetic. A single fric- 
tion of either the simple oil or the mixture named will sometimes 
be sufficient. But a good deal will depend on individual cutaneous 
sensibility ; and if a single application should fail, let it be re- 
peated until the result is obtained. After friction, a flannel 
moistened with the oil should be left on the part. At first mere 
warmth is excited, then obvious redness and great heat follow in 
from three to twenty hours, with almost innumerable vesicles, 
which soon maturate and leave small ulcers. If the application 
be made to a spot recently blistered, pustulation is more speedily 
effected and it is more abundant. It is needful to guard the 
eyes in operations of this kind, as contact there would be very 
injurious. 

Dr. Ainslie, in his work on the diseases of India, says that 
croton oil was thus employed there in 1813, in rheumatic affec- 
tions. In 1831 Andral praised it highly for the same end, and 
it has since that time become a favorite external mode of treat- 
ment. Andral usually wet a dossil of lint with the oil and 
rubbed this on the part smartly for a few minutes. Local palsy, 
painful affections of the throaty chronic bronchitis, and phthisis 
pulmonalis have been treated in the same way. In short, in all 
cases where it is desirable to establish counter-irritation and thus 
to relieve internal diseases, the croton oil mixture named above 
will be attended with the best results. 

The Journal de Chimie Medicale for 1839 has the case of a 
man, aged twenty-five, poisoned by croton oil, of which he swal- 
lowed two drachms and a half by mistake. The patient had been 
ill for some time of typhoid fever, and the croton oil had been 
ordered as an external application to the abdomen, to be rubbed 
on the surface by smart friction. The physician who saw him 
(three-quarters of an hour after the accident) found him in an 
alarming condition. The skin was cold and covered with a cold 
sweat. The pulse was so low as to be nearly imperceptible, and 
respiration quite laborious. The extremities of the fingers, as 
well as the lips, had the blue or livid hue of the collapsed stage 
of cholera. The tongue was cold to the touch, the pupils fixed, 
but not greatly dilated. The abdomen was exceedingly tender. 
At the end of an hour and a half the alvine evacuations were 
excessive and involuntary. The whole course of the oesophagus, 
as well as the stomach, experienced a sensation of burning. The 
coldness of the surface increased, the respiration and circulation 
grew more alarming, and the blue color pervaded the whole body. 



CUBEBS, USES OF. 399 

At length the skin became wholly insensible, and death closed 
the scene. . 

Dissection revealed no lesion of the mucous membrane of the 
stomach excepting a little softening. In the course of the di- 
gestive tube numerous ulcerations were seen, such as are said to 
be characteristic of typhoid fever. 

The treatment consisted in unavailing efforts to induce vomit- 
ing, as the stomach was no doubt somewhat paralyzed. Warm 
water and emetic solutions were freely given, but they did not 
dislodge the oil, which, no doubt, had passed into the upper 
bowels. 

The late Professor Richardson, of Kentucky, informed me 
that he knew a child to whom ten drops of croton oil were given 
by mistake, in one dose, without serious results. It was sup- 
posed that the oil was adulterated. 

The fatal effects above detailed, as the result of swallowing 
two and a half drachms, were obviously such as are common to 
narcotic poisons, though it should be classed rather among the 
narcotico-acrid poisons. 

In a case of actual poisoning by croton oil, the chief reliance 
should be on counter-irritants, aided by suitable means to con- 
trol the hypercatharsis and sustain the vital energies. 

Cubebs. Piper Oubeba. Java Pepper. — It is obtained from 
the Indian Archipelago and the Isle of France. It was employed 
in medical practice two hundred years ago, fell into disuse, and 
was revived as a remedy for gonorrhoea, gleet, &c. 

This article has a fragrant, agreeable odor, a pungent aromatic 
taste, with a little bitterness, and leaves on the palate a sensa- 
tion like that given by peppermint. It contains a volatile oil 
the loss of which by bad keeping or in process of time renders 
cubebs inert. This loss is more rapid when the medicine is kept 
in powder, as the oil escapes constantly, adhering to the sides of 
the vessel. 

The resemblance between cubebs and common black-pepper is 
striking. The large, heavy, plump, and most fragrant berries 
are the best, and should be selected. They may be kept in a 
tight vessel a long while, and should be pulverized or ground as 
occasion may require. 

Powdered cubebs, when in the stomach, act primarily on the 
nerves of that organ and increase its sympathetic energies, and 
through this medium the action of the heart and arteries is in- 
creased. The active principle is carried into the circulation, and 
finally impresses the kidneys, and the peculiar odor of the medi- 
cine is imparted to the urine. Not unfrequently doses of one or 
two drachms of the powder act smartly on the mucous membrane 
of the bowels, causing nausea and diarrhoea, with some febrile 



400 COPPER. 

excitement. If no cathartic effect ensues, the febrile heat is 
evidently increased, the palms of the hands and soles of the feet 
burn, the face is flushed, and there is headache. All these 
effects prove the stimulant character of cubebs, and all are often 
relieved by a free perspiration, which acts like a safety valve to the 
whole system. 

A popular use has long obtained in respect of cubebs that is 
frequently salutary and safe. I refer to its expectorant quality, as 
resulting from the swallowing of eight or ten of the berries by a per- 
son laboring under an ordinary cold. The difficulty of expectora- 
tion is often lessened, and the skin coated with moisture, by this 
simple expedient. 

From time immemorial, almost, gonorrhoea and gleets and vari- 
ous urinary derangements have been managed with cubebs. The 
Hindoo physicians were devoted to this practice, which cannot be 
safe when there is high inflammation, or febrile excitement is great. 

Leucorrhoea has been managed with this medicine, given in 
powder or in the shape of the oil of cubebs. The ordinary dose 
of the powder being from a scruple to thirty grains, three times 
a day, in milk ; of the oil, from five to fifteen drops make a dose. 
Besides the administration by the mouth, injections have also 
been employed at the same time. So also injections of the oil 
or powder have been successfully resorted to in the treatment of 
gonorrhoea by Yelpeau and other French practitioners. Piorry 
reports success in the use of injections in inflammation of the 
vagina. He added an ounce of finely-powdered cubebs to a pint 
of water, and had that quantity thrown up the vagina six times 
a day. He says he has also given forty-five grains per hour of 
the powder in treating the same disease. We must add that the 
practice is not very consistent with our notions of inflammation, 
but we give it as we find it. (See Edinburgh Medical and Sur- 
gical Journal, Oct. 1842.) 

Cuprum. Copper. — The filings of copper were formerly em- 
ployed, in the treatment of rheumatism, in teaspoonful doses, a 
clear proof that tke pure metal was not regarded as at all poison- 
ous. Coins of copper have remained for months in the oesopha- 
gus, stomach, and bowels, without doing serious mischief. The 
metal must be oxidated before it can do harm ; and yet a writer 
in Ranking' s Abstract^ vol. i. p. 2, declares that copper colic has 
been induced in the workmen in copper. They presented all the 
ordinary symptoms of severe colic from lead. Albuminous and 
mucilaginons drinks, with saline cathartics, gave relief. 

M. Chevallier has detected copper in the hair of workmen in 
that metal. It was not deposited on the hair, but actually 
within the substance itself. The hair, acted on by acetic or 
nitric acid, gave an acetate or nitrate. It is not said, however, 



COPPER POISONING. 401 

that any poisonous consequences ensued. (See London Lancet, 
June, 1850.). 

The first preparation to be noticed is the acetate of copper, 
sometimes called subacetate, diacetate, verdigris, &c. &c. The 
pure or prepared verdigris is made from the crude article, which 
is formed by exposure of sheet-copper to the action of acetous 
fumes evolved in the process of wine-making. The refuse of 
the grapes placed in heaps runs into the acetous fermentation, 
whereby the copper sheets are oxidized. The oxide so formed 
joins the acid, and hence the product of the salt. This is subse- 
quently purified and prepared for sale. It contains two equiva- 
lents of peroxide of copper to one equivalent of acetic acid, 
with six of water. The verdigris thus made is a very poisonous 
salt. A very interesting case of poisoning is reported in the 
American Journal of Medical Sciences, vol. v. p. 269, in which 
sugared water and the whites of eggs were successfully adminis- 
tered. They are the best antidotes. 

This salt is sometimes employed in small quantities to color 
articles of confectionery, and although the portion so swallowed 
be trifling, it may exert a bad influence. The same salt is some- 
times formed in preparing cucumbers for the state of pickles, by 
boiling with vinegar in copper vessels, and a good deal of gastric 
disease has hence resulted. Whenever the salt finds its way into 
food in considerable quantities it may set up acute inflammation 
of the stomach and bowels, or a low form of inflammation, which, 
becoming chronic, may end in dyspepsia. (See London Lancet, 
July, 1846. 

Very many sad consequences have resulted from eating food 
which had been dressed in copper vessels not well cleaned from 
the oxide of copper formed on the surface. M. Chiery, who 
wrote a thesis on the noxious quality of copper, observes "that 
our food is poisoned in the kitchen by the use of copper pans 
and dishes. The brewer mingles poison in our beer by boiling it 
in copper vessels. The sugar baker employs copper pans; the 
pastry cook bakes his tarts in copper moulds; the confectioner 
uses copper vessels; our pickles are boiled in copper or brass 
vessels, which are allowed to stand until cold, so that verdigris 
is plentifully formed by the action of the vinegar on the metal." 

Even our soda water is often made in old fountains in which 
the copper is no longer protected by the original tin coating 
within, so that the beverage is strongly marked with the copper 
taste ; and if we pass a stream of sulphureted hydrogen gas into 
a glass of it, a brownish color is struck at once. The fountains 
of glass and porcelain, now in use, are certainly a valuable im- 
provement, whose tendency will be, as I doubt not, very much to 
lessen the gastric discomfort of many persons. 



402 COPPER POISONING. 

Johnson, in his Essay on Poison, gives the detail of a sad 
catastrophe of three men killed, after excruciating sufferings, in 
consequence of eating food cooked in an uncleaned copper vessel 
on board the Cyclops frigate ; and besides these, thirty-three men 
were ill from the same cause. 

The poisoning of pickles is not always the result of accident. 
Thousands of jars are sold at high prices on account of the fine 
lively green color of the pickles, and which is effected by boiling 
copper coin with the vinegar. The taste is concealed by reason 
of various condiments present which go to neutralize the metallic 
taste of the copper. In the fourth volume of London Medical 
Transactions is a case of a young lady who amused herself, 
while some one was dressing her hair, with eating freely from a 
jar of pickles prepared in this way. She soon complained of 
pains in the stomach, and vomiting came on and continued almost 
incessantly for two days. After this her stomach was greatly 
distended, and on the ninth day death closed the scene. 

If the process of curing pickles in a copper or brass vessel be 
conducted rapidly and the contents be emptied immediately while 
hot, and especially if a large silver ladle be employed in the pro- 
cess, the pickles may escape the copper impregnation. It is the 
easiest thing in the world, however, to detect the copper, if it be 
there. Pour a little of the fluid matter into a wineglass and add 
a few drops of liquid ammonia, which will strike a deep blue if 
copper be in solution. 

The G-azette Medicale of November 26, 1842, gives the case 
of a man who was killed by verdigris. Masses of the article 
were found in the oesophagus, so as to induce the belief that he 
had taken a very large quantity. There was no evidence that 
vomiting hJfl been occasioned by the poison to any considerable 
degree, and it is inferred that death ensued from the violent nar- 
cotic influence of an excessive dose. There was a total absence 
of purgation. The stomach indicated congestion rather than in- 
flammation. 

The American Journal of Medical Sciences for October, 1842, 
has a notice of three workmen who died at Lyons from eating 
peas boiled in a copper vessel. M. D'Arcet, however, mentions 
the exemption from injury of some Cossacks who cooked in ves- 
sels lined with verdigris. He thought the animal matters neu- 
tralized the poison. 

The New York Medical G-azette of 1842 speaks of nine per- 
sons of a family in Oldtown, Maryland, who were taken violently 
sick after eating hominy boiled in a copper vessel in which it re- 
mained all night ; they were relieved by the early application of 
remedies. A cat which had eaten of it was affected in a similar 
manner. 



COPPER POISONING. 403 

The subjoined account of the poisonous action of the acetate 
of copper will be satisfactory to those who are not familiar with 
such matters, and they may serve as guides. They present the 
usual developments as seen in cases that terminate favorably, and 
are therefore the more important. 

The first case is given by Orfila, in his General Toxicology. 

"A journeyman jeweler swallowed at once a half-ounce of 
verdigris (acetate of copper) suspended in water. In fifteen 
minutes he was seized with colic pains and profuse vomiting and 
purging. In eight hours after, a physician saw him ; and then 
there was not much vomiting, but constant belching of a matter 
containing verdigris ; he was slightly salivated ; pulse small, and 
had a blue tinge round his eyes. In sixteen hours jaundice be- 
gan to appear. Three alvine discharges in the course of the 
night relieved his colic pains, and the next morning he ceased 
to vomit and the pain vanished. Still he complained of a copper 
taste, and the jaundice had increased. From this time he re- 
covered rapidly, and on the fourth day convalescence was con- 
firmed." It is to be regretted that the treatment is not given. 

The next case, taken from the Revue Medicate for 1829, pre- 
sents a picture somewhat different. "A lace-worker, twenty-six 
years old, of melancholic temperament, and who had before 
attempted to kill himself with water hemlock, (cicuta virosa,) put 
eight copper pieces into a glass of strong vinegar and left them 
there for seven days, (very deliberate business to be sure.) At 
two o'clock in the afternoon, having made a good dinner, he 
drank first one-half, and in fifteen minutes after the remain- 
der of his dose. Not satisfied with this, he washed the coins 
in more vinegar, brandy, and aniseed-water, and swallowed the 
whole. Three hours afterward he was found insensible. The 
muscles were violently contracted ; the limbs, in the intervals of 
the convulsions, were stiff; the teeth set; breathing interrupted ; 
pulse small, hard, and very slow, and the pit of the stomach 
tender on pressure. With difficulty he was made to swallow 
some hot water, but he did not vomit. In half an hour he re- 
covered his senses, and told what he had done. The white of 
eggs was given in large quantities, after which the convulsions 
ceased rapidly ; but he continued to hiccough till two o'clock in 
the morning. Next day the pulse was full, slow, and intermit- 
ting; the belly drawn in, hard, and very painful on pressure; 
skin pale ; convulsions partial and transient. Leeches were 
directed to the abdomen, followed by poultices. The white of 
eggs still given freely ; the warm-bath used, and opiate injections 
administered. In the evening he had colic, dyspnoea, great agi- 
tation, hiccough, and a hard, contracted pulse. Leeches repeated. 
The urine scanty and scorching. Passed a poor night, but was 



404 COPPER POISONING. 

easier next morning. The abdomen no longer tender; the pulse 
soft, and urine free. In fourteen days after admission he was dis- 
charged cured." 

The following interesting details, furnished in the London Lan- 
cet for 1846, by Surgeon Moore, of the British army in India, 
will be duly appreciated by all students of toxicology. 

" The form of disease which was most prevalent among the 
coolies returning from British Guiana to Calcutta, at the expira- 
tion of their contracts of ^service, may be described as acute in- 
flammation of the mucous membrane of the stomach and alimen- 
tary canal, which in its symptoms, course, and termination, pre- 
sented many of the characteristic features of acute idiopathic 
dysentery. 

" The cause of the outbreak of this particular form of disease, 
at the commencement of the voyage, was attributed at first to 
change of diet, change of climate, and to the noxious qualities 
of the Creek water, the vegetable and animal matters contained 
in which were at this time undergoing the process of putrefaction. 

"Although every precaution was taken to counteract the ill 
effects of these predisposing causes, the complaint did not seem 
to abate. For several successive days numerous cases of suffering 
from the same type of disease were brought aft for my inspec- 
tion by the sirdars. Perplexed as to the real cause of the dis- 
ease, then so rife on board, I was descending the middle hatch- 
way ladder to pay the morning visit to the patients in the hospital 
part of the ship when I was stopped by two or three coolies 
carrying plates loaded with cold rice and a quantity of ghee. In 
reply to my questions by what means they had obtained it, it 
appeared that this rice had been cooked one or two days pre- 
viously, and was laid aside by them as a reserve store, to eat in 
the middle of the night or early in the morning, before the rations 
were served out. When thrown overboard I examined the copper 
plates, which are invariably used by the natives of India, and 
found the surface coated with a green composition, evidently one 
of the salts of copper. 

" To neglect and slovenliness on the part of these return 
coolie laborers in cleaning their copper and brass utensils, was 
distinctly traced the immediate cause of the disease. 

" This greenish composition or verdigris, when not visible on 
the surface, we seldom failed to detect under the rims of their 
lothas and thalies in quantities sufficient to be scraped off with 
the edge of a penknife, and afterward proved by tests to be the 
acetate and muriate of copper. 

" This poisonous substance intermixing with their rice, fish, 
ghee, and pea-soup, produced in the greater number of cases a 
train of symptoms almost similar, and corresponding in general 



COPPER POISONING. 405 

•with the annexed abstract which I have copied from the Medical 
Register, in which all the particulars were entered at the time of 
occurrence. 

" In the evening, or on the following morning, a few hours 
after having eaten a meal of rice and dholl, they came complain- 
ing of violent pains and cramps in the stomach and lower bowels, 
constant vomiting of greenish and yellowish-green bile. When 
this was not ejected from the stomach their sufferings from dry 
retching proved more severe, and the feeling of constriction in 
the lower part of the chest and along the course of the oesopha- 
gus more distressing. Every twenty minutes or half hour they 
were necessitated to go to the chains and endeavor to evacuate 
the bowels; but in the attempt no feculent matter «was discharged: 
blood in small quantities, slimy mucus stools tinged with blood, 
shreds of lymph, and frothy ashen-colored secretions were passed 
from the rectum without affording to the patients the slightest 
relief. 

" The griping pains in the loins and sacrum, at the navel and 
in the iliac region, the tenesmus, and the burning sensation they 
invariably experienced about the rectum and close to the sphincter 
ani, they have all described as producing exquisite torture; 
pressure made over the different regions of the abdomen, in the 
epigastrium, and over the transit of the arch of the colon, usually 
caused a pungent pain. 

" In the commencement of the attack the symptoms were those 
of acute fever, pungent heat of the skin, headache, urgent thirst, 
loss of appetite, prostration of strength, furred and clammy 
tongue, foul taste in the mouth, rapid, small, and wiry pulse, 
varying from one hundred and twenty to one hundred and forty 
beats per minute. 

"In those cases where the form of attack was more rapid, 
more aggravated, more formidable in ifcs symptoms and progress, 
(from the quantity of verdigris mixed with the food and taken 
into the stomach having been in greater proportion,) the depres- 
sion of the vital powers was more marked ; the features of the 
patient were distorted ; his whole frame seemed to writhe under 
the pain ; the pulse was so rapid and at the same time so weak 
as scarcely to be felt ; the skin became cold ; the extremities 
benumbed ; the secretion of urine in a few cases was suppressed, 
in others it was retained in the bladder. The treatment which 
proved most efficacious in arresting the progress of these symp- 
toms and removing the disease consisted in administering imme- 
diately an emetic of twenty grains of ipecacuanha and one grain 
of tartar emetic, and ordering the patient to drink copiously of 
barley or congee water. In six or eight hours afterward, ten, 
twelve, or fifteen ounces of blood were taken away by venesec- 



406 COPPER POISONING. 

tion, according as the strength of the patient and the state of the 
pulse indicated. In the evening another emetic of ipecacuanha 
alone was given, and when practicable the patient was placed in 
a bath of warm salt water ; but whenever this was rendered im- 
possible, from the rolling and lurching of the vessel in heavy, 
squally weather, blood was abstracted from the epigastric and 
infra-umbilical regions by means of cupping, and warm stupes 
were afterward applied for several hours to the abdomen. Castor 
oil in large doses, repeated according to circumstances, proved 
the safest and most efficacious purgative in carrying off the fecu- 
lent matter lodged in the intestines. 

" Under this mode of treatment, with few exceptions, the 
violent character of the original symptoms has been subdued ; 
the acuteness of the fever has been checked in the very onset ; 
the pulse has become fuller, less wiry, less frequent ; the torturing 
pains in the abdomen have been partially, in some cases com- 
pletely, removed ; the incessant discharges of slimy, bloody 
mucus from the intestinal canal have in a great measure been 
checked. 

" So far the treatment pursued in this the first or acute stage 
of the disease has proved singularly successful ; but in almost all 
the cases which have come under my observation the mucus dis- 
charges from the intestinal canal have continued frequent, gene- 
rally six or eight motions in the twenty-four hours, accompanied 
by tenesmus. In this subacute form of inflammation of the 
mucous membrane, our chief reliance in the treatment was placed 
upon opium and its different preparations, combining forty drops 
of the tincture with fifteen grains of rhubarb, or half a drachm 
of Gregory's powder ; quarter-grain doses of the opium in 
powder, combined with two grains of ipecacuanha and three 
grains of blue-pill, given every second hour. After each pill an 
ounce of chalk-mixture was ordered. 

" In addition to these internal remedies much benefit was de- 
rived from the application of small mustard cataplasms or blis- 
ters to those parts of the abdomen where the greater amount of 
pain on pressure was seated. The diet in each case was re- 
stricted to arrow-root ; rice, dholl, ghee, salt fish, articles of daily 
food, were strictly prohibited; and when the condition of the 
patient admitted, port wine mixed with the arrow-root was at once 
prescribed. 

" In the majority of cases the acuteness of the symptoms 
once removed, a favorable termination of the case has taken place 
in five or six days ; the convalescence of the patient has been 
established satisfactorily on the eighth or tenth day. In others, 
whose constitutions have received a more severe shock, recovery 
has been more protracted; while in a third class the disease, 



COPPER POISONING. 407 

slow in yielding to the influence of medicine and resisting those 
remedial measures which proved successful in the two former 
classes, has ultimately assumed all the characters of chronic 
dysentery. 

" On the 20th of June, 1843, when we crossed the equator in 
west longitude 23' 45", seven weeks' sail by the day from De- 
merara, the sirdar ran to the cabin to inform me that one of the 
stoutest coolies on board was seized with violent cramps in the 
stomach, cramps in the limbs, frequent vomiting and purging of 
blood. He was so ill that he did not think he could live half an 
hour. He had been slightly ill in the course of the day from 
gnawing pains in the stomach, but made no complaint until the 
frequency of the purging attracted the attention of his relatives. 

" His sufferings from pains in the stomach, in the intestines, 
and at the anus, were excruciating ; his features were distorted ; 
pulse small, frequent, wiry ; thirst urgent ; constriction of throat 
and chest distressing ; in fact, the symptoms presented in this 
case were the same as those already recorded, but in their most 
aggravated form. 

" Conjecturing, from the suddenness of the attack, from the 
general features of the complaint, and from a corresponding 
train of symptoms observed in parallel cases at a previous time, 
I did not hesitate to express to my worthy friend, the captain of 
the vessel, an opinion as to the probable cause ; and immediately 
commenced an inspection of his brass and copper utensils. On 
the internal surface there still remained a coating of verdigris 
sufficient in quantity to indicate the immediate cause of the at- 
tack, and more than sufficient, if mixed with food, to produce a 
similar train of symptoms in many other cases. 

" The same line of treatment so strikingly successful in former 
cases was pursued in this, but not attended with the same good 
results. The treatment advised by those who have written on 
the subject was next resorted to, but without avail ; the relief 
afforded was merely temporary ; the disease was beyond the reach 
of medical skill ; the case ran its course rapidly, and terminated 
fatally. 

u In the post-mortem examination we found on the internal 
surface of the stomach, from the cardiac to the pyloric extremity, 
and for a short distance on the internal surface of the oesophagus 
near its termination in the stomach, extensive and deep-seated 
inflammation of the mucous membrane and subjacent tissues ; the 
shades of red varied in different parts from a bright vermillion 
or a bright scarlet to a deep-red or violet color. The patches of 
dark red approaching to a brownish color were comparatively 
small and circumscribed, situated in general beneath the mucous 
membrane of the under surface of the stomach. The mucous 



408 COPPER POISONING. 

membrane corresponding to these patches was soft, tumid, pulpy, 
but not excoriated, and free from the appearance of having 
sloughed. At the pylorus the membrane was intensely inflamed, 
glistening, and tumid, from a quantity of serous fluid exuded be- 
neath the submucous cellular tissue. 

" In the duodenum there existed the pathological appearances 
of a high state of inflammatory action ; throughout the small 
intestines also we found decided traces of inflammatory action in 
the mucous membrane, although scattered irregularly over the 
surface. The mucous membrane of the large intestine presented, 
in like manner, an appearance of vascularity; in the rectum, 
also, the inflammatory action had commenced, but was limited in 
extent. 

" Within the peritoneal sac somewhat more than eight ounces 
of saffron-colored fluid were found: the peritoneal coat of the 
small intestines (the jejunum and ileum) was numerously studded 
with minute circular dots or specs of a bright scarlet-red color. 
On the upper surface of the arch of the colon, in its ascending 
and descending divisions, these inflammatory spots were exten- 
sively, but less numerously, scattered. Between the peritoneal 
and muscular coats of the stomach, an irregularly-shaped patch 
of effused blood was noticed ; and on the lateral and inferior 
surfaces of the same viscus, vascularity of the peritoneal coat, 
and sub-peritoneal exudations of blood and lymph were traced 
to a short distance. The folds of the intestine were not agglu- 
tinated together by lymph, nor were there any traces of it in 
the peritoneal sac. 

"We need not a more demonstrative proof of the deleterious, 
poisonous, fatal effects produced by the intermixture of verdigris 
with the food, and its introduction into the stomach, than the 
case under consideration. The symptoms indicated poisoning ; 
the inspection of the copper vessels confirmed us in the opinion 
expressed; — the post-mortem examination cleared away from 
our minds any doubt which may have existed. 

"In England, these cases are not often met with; the servants 
are careful, cleanly, and in general very particular in using cop- 
per vessels. Not so in India. In Calcutta, in particular, I have 
met with cases among Europeans which in their symptoms bore 
so striking a similarity to those already mentioned that little 
doubt has remained on my mind that the attack had originated 
in the intermixture of verdigris with their food and its intro- 
duction into the stomach. 

"The Bengalee baboorchees, khansamahs, khitmudgars, and 
musalchees, to whom almost every thing connected with the 
kitchen is intrusted, are not at all times very particular in cook- 
ing the Sahib's khanaw in bright, unstained copper vessels. I 



BLUE VITRIOL. 409 

have little doubt that if more attention were paid by the inhabit- 
ants of Calcutta to the carelessness of their servants in this 
respect, and if the kitchen utensils were more frequently in- 
spected by some trustworthy servant in the establishment, we 
should hear of fewer instances of several members of the same 
family being attacked on the same evening or in the same night 
with violent symptoms resembling those of cholera or acute dys- 
entery: fewer families (in consequence of a little precaution 
against such occurrences) would be placed in mourning, from 
some one member having fallen a victim to it." 

We cannot doubt that many very violent attacks of bowel 
disease in this country are occasioned by similar neglect to that 
detailed above. It is important for medical men to be aware of 
the facts in this relation. Hitherto the subject has been sadly 
neglected. 

In addition to the antidotes named above, it may be added 
that the salts of copper are decomposable by zinc and copper- 
filings in the dose of from a half-drachm to two drachms, 
followed by the free use of warm water. 

Acetate of copper is escharotic. The salt should be heated 
so as to expel all its water of crystallization. An efflorescent 
mass is thus obtained, of which a drachm must be rubbed with 
an ounce of simple cerate, for use. It is a good stimulant to 
indolent ulcers. 

Ammoniuret of Copper. Ammoniated Copper. Sulphate of 
Copper and Ammonia. — Either of these names will answer for 
an old remedy that is yet employed by some practitioners in 
chorea and other diseases of the nervous system. It can be 
readily made by triturating two parts of sulphate of copper with 
three of carbonate of ammonia in a glass mortar until the salts 
become quite moist or semi-fluid. The mixture has a rich blue 
color and a strong ammoniacal odor, to retain which the process 
of drying must be carried on carefully by a very gentle heat. 
The product is to be placed in well-stopped bottles. The effect 
of the action of the salts on each other is to expel the carbonic 
acid from the volatile salt and to form sulphate of copper and 
ammonia. The taste is very styptic and metallic. A scruple 
dissolves in one ounce of water. The dose is one-eighth of a 
grain to one grain three times a day, in pill made with crumb of 
bread, or soft vegetable bitter extract. 

Sulphate of Copper. Blue Vitriol. Blue Copperas. Blue 
Stone. Bimlphate of Copper. — It contains two equivalents of 
sulphuric acid to one of peroxide of copper. It is largely made 
from the native sulphur et by the conjoined agency of heat and 
exposure to the air. It is found abundantly as a native product 
also. It is soluble in water pretty readily, and the solution has 

27 



410 USES OF BLUE VITRIOL. 

a harsh, acrid, and styptic taste. The crystals are slightly efflo- 
rescent, and are not acted on by sulphuric acid, even with the 
agency of heat. This is not so with the acetate, and we are 
thus able to distinguish these salts, should there be doubt. 

The medicinal uses are various, being employed as an emetic, 
tonic, astringent, and escharotic. It is called a prompt emetic, 
because of its quick action and consequent fitness for the dis- 
lodgement of poisons from the stomach. For this object a half 
or whole drachm is dissolved in six ounces of warm water, and 
a third of the solution administered every ten or fifteen minutes 
till free vomiting ensues. But the emetic power is available also 
in smaller doses in the management of croup. Dr. Serlo, an 
Italian physician, speaks in high praise of this remedy in what 
was plainly that variety called inflammatory or membranous 
croup. He had treated a little girl with leeches, calomel, tartar 
emetic, and blisters, but the disease would not yield. He thought 
of Hoffman's method of using sulphate of copper, and gave the 
child four grains dissolved in a little water. In five minutes 
vomiting came on, followed by the expulsion of pieces and shreds 
of false membrane, after which all the bad symptoms quickly 
subsided. Subsequently, forty cases of decidedly inflammatory 
croup were treated with the same medicine, in conjunction with 
the usual antiphlogistic measures, and all recovered but four, 
who were in a hopeless state before they were seen by the doctor. 
The same gentleman gave the sulphate in what he calls laryngo- 
tracheitis of infants, a disease closely resembling croup, and 
which I suppose to be substantially the same thing. Three 
grains of the salt were mixed with six of white sugar and ad- 
ministered in one dose, with effective vomiting as the result- 
After this, quarter-grain doses with five grains of sugar were 
given every two hours, to keep up a nauseant and sedative 
action. Those who desire further information may consult the 
American Journal of Medical Sciences, vol. xvii. 

As an astringent, Dr. Elliotson gave the sulphate in diarrhoea 
of an obstinate kind, occurring in St. Thomas's Hospital, and he 
found it decidedly superior to all other astringents. It is quite 
probable that the tonic powers of the salt had something to do 
in the premises. The dose was from one and a half to three 
grains three times a day, for adults, as a thing of course. It 
is best given in pill made with extract of quassia. In obstinate 
cases of diarrhoea in private practice I have combined the sul- 
phate of copper with the sulphate of morphia. The disease is 
frequently attended with painful sensations that require an ano- 
dyne. Two grains of the copper salt with a sixth of a grain of 
the salt of morphia may be given twice or thrice a day. As a 
tonic, blue vitriol has long been employed alone, or in com- 



USES OF BLUE VITRIOL. 411 

bination with sulphate of quinine and other articles. In in- 
termittent* in very feeble persons this combination of tonic 
and anti-periodic medicine is often valuable. In epilepsy and 
other chronic nervous diseases the long-continued use of small 
doses of the sulphate of copper is sometimes salutary. In addi- 
tion to a tonic agency an alterative action is in operation, and 
both together bring the result. The dose is an eighth of a grain, 
which may be gradually increased, the dose being taken three 
times a day. This small dose, with half a grain of sulphate of 
quinine, gradually increased, has been signally beneficial in 
chorea attended with great debility. 

The counter-irritant action of this salt is sometimes useful in 
the treatment of subacute ophthalmia. Four grains added to 
six ounces of rose-water, or infusion of slippery elm, make an 
excellent collyrium, to be used frequently through the day. 

The London Lancet for July, 1846, states that Mr. Lloyd was 
in the practice of curing itch effectually by a lotion made of an 
ounce of sulphate of copper and a pint of water. He applied 
this freely after washing the surface thoroughly with warm water 
or soapsuds. He seldom knew the lotion to fail. 

The eschar otic property of blue stone is familiar to all. The 
common people use it to "keep down proud flesh," as they say. 
The same result, substantially, is sought by practitioners, as in 
ulcerated sore throat, for which five grains of the salt in fine 
powder, mixed with an ounce and a half of syrup of squills, is a 
good application. A teaspoonful or two is taken into the mouth, 
and then a tablespoonful of water, and the mixture is freely 
gargled. If a portion should pass down the throat it will be all 
the better. The escharotic action is slight, yet often useful. 
Oancrum oris, gangrenous ulceration of the mouth of young 
children, has been well managed by the use of this salt. The 
disease occurs in hospitals for children, and is often quite fatal. 
It was so in the Children's Asylum in Philadelphia, in 1826, 
where it occurred as an epidemic. Dr. Coates gives a good 
account of it in the Worth American Medical and Surgical 
Journal, vol. ii., where the following successful formula is 
recorded : — 

Take of sulphate of copper, two drachms ; 
Powder of cinchona, a half ounce; 
Water, four ounces. 
Mix, and apply twice a day to all the ulcerations and excoriations. 

The remedy was furnished, it is said, by an old lady. 

Injections of sulphate of copper are sometimes very useful in 
leucorrhoea. From ten to thirty grains may be dissolved in five 
ounces of water, and a third be thrown up the vagina at bed- 
time. 



412 ANGUSTURA BARK. 

The following preparation of copper is given a3 a new form of 
lotion in purulent ophthalmia: — 

R. — Cupri sulph grs. ij; 
Vini opii, gi; 
Aquas dist. ^vij. 
Tfy. — Fiat lot. Apply freely, with a soft camel' s-hair brush, three times a 
day. 

This has answered well in some cases that have resisted the 
nitrate of silver. — Assoc. Med. Journ., Sept. 27, 1856. 

In Dr. Blair's book on the yellow fever of British Guiana, 
page 146, it is stated that the following prescription is decidedly 
prophylactic in respect of a periodical inflammatory fever some- 
times met with in Demerara. It is necessary to continue it some 
three or four months : — 

R. — Sulph. cupri, gr. i; 
Antim. tart. gr. \. 

Made into a pill with a little conserve of roses. To be taken 
twice a day. It usually nauseates till after the first week. 

The incompatibles of this salt are the alkalies, the alkaline 
carbonates, borax, acetate of ammonia, tartrate of potash, mu- 
riate of lime, acetate of lead, corrosive sublimate, all astringent 
vegetable infusions and tinctures. 

We have seen that copper is poisonous by becoming oxidated 
and changed into a salt. The sulphate is poisonous, though less 
violently so than the acetate. Bakers add it to dough to 
whiten bread. Thirteen persons were tried at Brussels for this 
offence, and fined and imprisoned. They called it blue alum, and 
pretended to be ignorant of its true quality. The dose thus ad- 
ministered is small, but the daily use is finally deleterious. 

The poisonous action is more apparent when large quantities 
are swallowed by mistake. Severe vomiting, gastric pains, colic, 
tenesmus, bloody discharges, vertigo, cramps, convulsions, ensue. 
The stomach must be emptied and the whites of eggs freely 
given in sugared water. The salt is thus decomposed and the 
oxide thrown down. Zinc filings are also employed, as before 
stated. Bleeding, general and local, may be necessary, to 
subdue high arterial action and gastric inflammation. Mucila- 
ginous drinks, after the salt is decomposed, will be useful. 

Cuspari^: Cortex. Angustura Bark. — This article was 
formerly very much in use. It is tonic, stimulant, and aromatic, 
in doses of from five to twenty grains. 

This bark yields its properties to water and to proof spirit. 
Its properties depend on the presence of gum, resin, volatile oil, 
and a peculiar bitter principle. The bitter principle has been 
called angusturin or cusparin. 



STRAMONIUM A POISON. 413 

The angustura bark is not likely to be adulterated nor con- 
founded with other barks. The transverse section of the bark 
touched with nitric acid becomes very red, in consequence of the 
presence of brucia, and the rusty spots on the epidermis are 
made of a dark green by the same acid. 

Daphne Mezereon. This is the only species of mezereon in 
use in this country. The plant is very acrid; the berries have 
the same property, and are decidedly poisonous. The bark of 
the root [cortex radicis mezerei) is officinal, and enters the com- 
pound sarsaparilla decoction. A very volatile oil and resin gives 
it the acrid quality. The bark, steeped in vinegar, is vesicating. 
It is also stimulant and diaphoretic. In cutaneous diseases it is 
probably entitled to some regard, but in syphilis it is worthless. 

The decoction is made by adding an ounce to a pint of water 
and boiling a few minutes. Of this four or five tablespoonfuls 
may be taken three times a day. In overdoses this decoction is 
poisonous, from which it is to be inferred that the mezereon is 
possessed of considerable medicinal power. The poison is to be 
met by diluents and dilute acids, after properly emptying the 
stomach. 

Datura Stramonium. Thorn Apple. Jamestoivn Weed, 
&c. &c. — This is a native of the United States, but found in 
nearly all countries. It is an exceedingly troublesome weed to 
farmers, and is very offensive when handled. But it is so uni- 
versally known that I need not waste time with a description. 
Every part of the plant has a strong, disagreeable odor, a bitter 
and nauseous taste. When chewed it tinges the saliva of a deep 
green, and few animals will even taste it. It is an active nar- 
cotic poison, and this quality resides in every portion of the 
plant. It sets up vertigo, delirium, torpor, loss of memory, ex- 
cessive thirst, paralysis of the limbs, dilatation of pupil, &c, and 
if relief be not- soon had the issue may be fatal. Professor 
Barton tells of two British soldiers who ate of the plant by mis- 
take, one of whom became furious and ran about as if he was 
mad ; the other died with symptoms of tetanus. 

In Barton s Medical and Physical Journal, vol. i., it is 
asserted "That the inhabitants of Vincennes, Indiana, had this 
plant cut down and destroyed, alleging that its effluvia gene- 
rated remitting fevers, which were not known there until the 
stramonium had been introduced into the neighborhood." 

Not only the flowers, but the leaves, seeds, stalk, root, and 
every part of the plant are poisonous. The energy of the poison 
is said to reside in a peculiar principle called daturia. 

During the American war, poisoning occurred from the use of 
the leaves for greens. Some who partook of these became fu- 
rious, and ran about like madmen. Others were seized with 



414 DATURIA. 

tetanic spasms, and died. The Boston Medical and Surgical 
Journal for 1836 has the case of a family poisoned in a similar 
way, only by design. A wretch who had a grudge against the 
family put a quantity of the leaves into a pot in which some salt 
beef was boiling. The greens were eaten, of course, as part of 
the meal. A physician was called in about an hour after dinner, 
when the countenances had a wild, idiotic look ; the pupils were 
greatly dilated; the sensorial functions perverted; the muscular 
system jerked as in chorea. The children were laughing, sing- 
ing, and dancing. 

An emetic of sulphate of zinc with ipecacuanha brought away 
a large quantity of the stramonium, after which camphor, car- 
bonate of ammonia, and a warm aromatic infusion, caused the 
narcotic symptoms to subside. 

Cases are recorded in all our journals of the poisonous effects of 
the seeds, which children are apt to eat, not knowing their dele- 
terious quality. These occasionally operate in the manner just 
spoken of in reference to the boiled leaves ; but sometimes they 
induce convulsions, locked jaw, and insensibility, that continue 
till death closes the scene. 

All the unpleasant symptoms of poisoning by stramonium 
may be relieved by the timely evacuation of the stomach in most 
cases. Notwithstanding the activity of the seeds, Lyell asserts, 
in his G-eology, vol. iii. page 44, that the quacks of Great Bri- 
tain formerly gave them as an emetic. According to Orfila, the 
effects of this narcotic closely resemble those of belladonna, dif- 
fering only in the more exciting operation of the former on the 
brain and nervous system. 

The evacuation of the stomach in cases of poisoning by stra- 
monium should be speedy and potent ; and to this end a drachm 
of the sulphate of zinc should be dissolved in a common teacup- 
ful of warm water, a third of the solution being given every 
ten minutes until the desired effect is induced. Immediately 
after this operation the patient should drink freely of vinegar 
and water, and as soon as convenient have the bowels freely 
evacuated. 

The active principle of stramonium resides in an extractive 
matter, which Mr. Brande procured from the seeds. It is an 
alkaloid, and known under the name of daturia or daturine. 
It is not employed at present as a remedial agent, the extract 
of stramonium being preferred. This can be readily made from 
a very strong decoction of the seeds by evaporation, taking care 
not to burn the product by an intense heat. Some prefer the 
inspissated juice of the mature, green leaf, which can be made 
annually in large quantities, and with very little care can be 
preserved for use. The leaves must be pounded in a clean glass 



USES OF STRAMONIUM. 415 

mortar, and the juice being collected in a saucer should be ex- 
posed to the sun until reduced to a pliable mass. Pack it in 
well-covered earthen jars, and keep them in a cold place. I 
advise medical men to prepare this article, and to give it a trial 
in lieu of the extract. 

The stimulating property of stramonium was long ago known 
to the Turks, who when unable to procure opium resorted to it 
as a substitute ; the Chinese have also been in the habit of add- 
ing it to other articles for the purpose of making an intoxicating 
beer. 

It is said that Stoerk, of Vienna, was the first to employ 
stramonium as a remedial agent in Europe, and he valued it in 
the treatment of mania. In imitation of him, Professor Barton 
tried the article in the same disease in the Pennsylvania Hospital 
during my pupilage, but with no marked success. The Swedish 
physicians were partial to it in mania and epilepsy. It has been 
tried very often in this country in what has been called tie dou- 
loureux, a form of neuralgia that invaded the face ; but I do not 
think it is now regarded with favor. 

The practice of smoking stramonium in tobacco pipes, so often 
resorted to among us for the relief of spasmodic asthma, had its 
origin in Ceylon. The good effects most probably depend on 
its expectorant quality; and this is the secret of its success in 
the hands of Dr. John Davy in chronic coughs with nightly ex- 
acerbations, although he frequently gave but an eighth of a grain 
of the extract, and rarely more than one grain at a dose. Similar 
doses have been given with good effect in various forms of rheu- 
matism, but most probably combined with other articles. There 
are some cases on record of uterine irritation and painful men- 
struation very materially benefited by minute doses of the ex- 
tract. 

Two ounces of the bruised seeds digested in sixteen ounces of 
alcohol for two weeks yield a tincture that has been employed 
in lieu of the extract. The dose is from ten to twenty drops. 
It has also been used externally to parts affected with neuralgia. 
A small quantity is laid on the spot several times in a day and 
rubbed in by smart friction. Persistence in this plan daily for 
several weeks has dissipated the pain and removed the disease. 

The dose of the extract made as above is half a grain, to be 
increased gradually to six or eight grains three times a day. Of 
the inspissated juice a quarter of a grain will suffice, to be aug- 
mented daily. Three grains of the powdered leaf make a dose 
to begin with, and it may be carried up to twenty or thirty 
grains. 

As an external application an ointment made of the green 
leaves has long been popular in the treatment of hemorrhoids 



416 FORMULA FOR DECOCTIONS. 

and burns. The ointment is prepared by gently simmering the 
leaves in lard or sweet oil and straining while hot ; it has a bright- 
green color. Though safe as an application to piles, it is not so 
to a burnt or scalded surface, especially of large extent. The 
fresh leaves, bruised and steeped in hot vinegar, make a poultice 
that was employed by Plenck to soften and remove hard and 
painful tumors of the breasts of females. 

Decoctions. — This term is often confounded with infusions. 
Both may be made with hot water; but the latter are not 
subjected to ebullition, as the former are. We never fail to boil 
when we make a decoction, and it is proper to know and recol- 
lect that some articles are injured by this process, while the 
mode of infusion does not exert a deteriorating influence. The 
act of boiling more perfectly extracts the medicinal properties of 
some articles than mere infusion, whether cold or hot. But if 
an article that contains much volatile matter be subjected to the 
process of decoction, the high temperature and its continued 
action drive it off and it is lost, no matter how important it may 
be as a medicinal component. The aromatics without exception 
belong to this class, and they are often very valuable agents. 
Many of the roots and barks and leaves afford a better medicine 
in the form of decoction than in any other way, and may be so 
prepared, if they contain no active volatile matter that a boiling 
heat would dissipate. Colchicum, hemlock, digitalis, monkshood, 
and some other articles would be greatly impaired, and in some 
climates totally destroyed, so far as the medicinal power is con- 
cerned. 

As a general rule, all decoctions are best prepared in new 
and clean vessels of white earthenware, or in vessels of glass, 
when they can be conveniently employed. Whatever be the 
material, the vessel should be perfectly clean and furnished 
with a cover, which not only accelerates the operation but in- 
sures a neater and better product. 

The following formulae for decoctions will probably be found 
convenient for occasional reference : — 

Compound Decoction of Calumbo. Compound Decoctions of Cinchona. 

R.— Rad. Calumb. contus. 1. R.— Pulv. cort. cinchon. gi; 

Lign. quass. contus. aa gij ; Aquae, Oij. 

Cort. aurant. contus. £i ; Boil these for a quarter of an hour, 

Pulv. rhei, £)i; then add 

Potass, carb. £i; Fol. sennae, !§Ss; 

Aquae, |xx. Rad. zingib. contus. gi; 

Boil down to fifteen ounces and Sodae sulph. gss. 

strain, and then add Macerate for two hours, and add 

01. lavend. TT|x- S y r - limonis, %i. 

Mix. Take a tablespoonful fre- Mix. 
quently. 






FORMULA FOR DECOCTIONS — DEPURATION. 



417 



2. R. — Cort. cinchon. contus. ^ss; 

Aquae, Oi. 
Boil these for half an hour, and 
add 

Rad. serp. virg. cont. ^ij. 
Digest for an hour, strain, and 
add 

01. cinnam. ^i; 
Elix. vitriol, ^iss. 
Mix. Half a wineglassful may be 
taken four times a day. 

3. R. — Cort. cinchon. opt. ,^iij; 

Rad. gent, contus. ^ss; 
Rad. rhei contus. giiss ; 
Potass, carb. ^i; 
Aquas, Oij. 
Boil for an hour, and strain, and 
add 

Syr. aurantii, ^iss. 
Mix. Dose, one or two large spoon- 
fuls. 

4. R. — Pulv. cort. cinchon. ^vi; 

Rad. serpentar. ^ss; 
Cort. aurant. sjij; 
Cort. cinnam. gss ; 
Aquae, Ibiss. 
Boil to one pound, and take a -wine- 
glassful for a dose. 

Compound Decoction of Gentian. 

R. — Rad. gentian, cont. ^ss; 
Rad. calam. aromat. giij ; 
Aquae bullient. Oi. 
Digest for two hours in a close vessel, 
and, when cold, strain ; and add 
Ether sulphuric, ^ij ; 
Syr aurantii, ^ss. 
Mix. 



Decoction of Seneka Poly gala. 
R. — Rad. senekae cont. ^vi; 
Aquas, Oij. 
Boil down to Oi, and add 

Rad. glycirrh. cont. ^ss. 
Digest an hour, and strain. 

Decoction of Dandelion. 
R. — Rad. taraxaci, t ^iv; 
Potass, bitart. 
Sodae bicarb, aa ^ss ; 
Aquae, ibiij. 
Boil down to two pounds, and add, 
when cold, 

Spt. nit. dulc. ^ss. 
Mix. 

Acetic Decoction of Hops. 

R. — Humuli lup. j|ijj; 
Aceti fort. Oi ; 
Boil for half an hour, and apply hot, 
as a poultice. 

Decoction of Pomegranate. 

R. — Cort. punic. granat. ^ij ; 
Aquae, Oij. 
Macerate for twenty-four hours, and 
then boil to Oi, and strain. The whole 
to be taken in three doses in two hours, 
as an anthelmintic. 

Decoction of Pinkroot. 
R.— Rad. spigel. |i; 
Fol. sennae ^ss; 
Aquae, bullient. Oi. 
Simmer for ten minutes in a close 
vessel, and strain. Give from a table- 
spoonful to a wineglassful three times 
a day, as an anthelmintic. 



Depuration. — This is a mode of practice advocated by Dr. 
Golding Bird in a course of lectures given before the Royal 
College of Physicians, in London, in 1848. The chief object 
was to point out the advantages to be derived in the treatment 
of disease from a rational reliance on the light afforded by the 
researches of modern chemistry, which are shown to be more 
particularly applicable to the direction of such therapeutic agents 
as have the power of stimulating the emunctory organs to dis- 
charge effete matters from the system — an operation styled by 
Dr. Bird the depuration of the blood. 

Here is at once an epitome of all that is practically valuable 
in the doctrine of the humoral pathology. The impurity of the 
blood is the recognized basis of disease, and the separation of 
that impurity the means of cure. 



418 DEPURATION OF THE BLOOD. 

While the lecturer values the importance of the lungs, the 
liver, and the skin, as outlets for the same grand end, he endeavors 
to show the superiority of the kidneys, not only because their 
function cannot be shared with other organs, but because they 
may in some degree compensate for the failure of all others in 
this needful work. For this reason he extends the well-known 
alterative principle to the kidney instead of restricting it, as has 
generally been done to the liver ; and he proposes to regard 
certain diuretics not as hydragogues merely, but as renal altera- 
tives. 

With this intention, the author announces a fact which he be- 
lieves was never before stated, viz., that we have agents known 
as diuretics which are able to increase the metamorphosis - of 
tissue, and at the same time, by stimulating the secretory appa- 
ratus of the kidney, to carry the tissue thus metamorphosed out 
of the body. In taking a practical view of diuretic agents, Dr. 
Bird divides them into two classes : those which simply increase 
the quantity of water, and those which act as renal alteratives. 

To the former class belong all those agents which out of the 
body exert no chemical action on organic matter and seem to be 
incapable of increasing the solid matter in the urine, as copaiba, 
broom, juniper, squills, &c. &c. In the second series are in- 
cluded those reputed diuretics which exert the influence alluded 
to and act as depurating agents. Among these are named the 
alkalies, their carbonates and other salts, with those acids which 
are convertible into carbonic acid in the animal economy ; such 
as the lactates, citrates,- and acetates. These are supposed not 
only to augment the bulk of the urine, but also to exert a direct 
chemical action on the tissues, and to increase the quantity of 
the solids. That they do so is proved by actual experiment the 
results of which the author has adduced. 

The doctrine of depuration of the blood is a very old one, much 
older than Dr. Bird. We regard it as no less true for the valu- 
able researches of this intelligent physician. 

Dr. Bird thinks that one of the most important elements in 
the treatment of the old physicians was the water of the potions 
employed, and which was given not by tablespoonfuls, but by 
pints. He remarks that if a patient take an extra pint or two 
of water, there being no organic lesion to prevent, he will ex- 
crete a large bulk of urine from the necessity created for pump- 
ing off the excess of fluid taken into the stomach. Thus a pint 
or a quart of water proves a diuretic, as our daily experience 
may serve to evince. But one may ask, What is this but the 
mere drawing off the excess of water, and how can such a process 
be a proof of blood-depuration ? The proof may be had by 
collecting the urine and calculating the amount of its solid con- 



DEPURATION OF THE BLOOD. 419 

stituents. It will thus be manifest that not mere excess of 
water has escaped, but with it has been washed out of the system 
a certain quantity of the solid debris. Becquerel first pointed 
out this truth, and enforced it by many experiments. Nor is it 
difficult for a careful observer to. satisfy himself, by collecting all 
the urine he passes in twenty-four hours and noting the propor- 
tion of solid matter it furnishes. Let him take two, three, four, 
or five bottles of Seltzer water on the next day, in close succes- 
sion, and the result of his investigation will be still more striking. 
Observations of this nature afford a key to the many undoubted 
cures effected at mineral springs. 

A man sick of some chronic disease which, like rheumatism, is 
the product of unhealthy constituents of the blood, starts for 
one of the Brunnens, or Spas, and with doubtful devotion swal- 
lows a prodigious quantity of the warm, bubbling water. His 
stomach is positively distended, it may be, and he fears the re- 
sult. Presently he begins to secrete an abundance of urine, and 
is engaged alternately in drinking and urinating the whole morn- 
ing. He has nothing else to do, and is obeying the advice of his 
medical counsellor. At the same time, as far as practicable, he 
takes active exercise, carefully avoiding fatigue. The wear of 
tissue is thus augmented, and the copious water-bibbing positively 
aids the metamorphosis of tissue and washes its results out of the 
system. These and similar facts account for the vaunted suc- 
cess of hydropathic quackery, which clears out the effete matters 
by a literal washing out through the solvent powers of the vast 
quantities of water consumed by the patient. The old tissues 
thus cleaned and purified are fitted for the deposit of new 
structure, and hence the salutary results which are sometimes 
permanent. The deep-red hue of the urine soon fades away, 
and the natural straw color is restored, because the lithates and 
the lithic acid, previously in excess, have been diluted and carried 
out by the kidneys. 

The action of depurating remedies, even by the kidneys, is, 
therefore, as certainly alterative as is the action of small doses 
of mercury, or nitrate of silver, long continued. In reference to 
the cure of rheumatism, acute or chronic, no plan offers better 
prospects of success than that of depuration, or elimination by 
the kidneys, the skin, and the bowels. Hence the value of this 
mode of practice, which merits a much more attentive study than 
has yet been given to it. We are much indebted to Dr. Bird for 
his zealous labors in this department. 

As the pith of Dr. B.'s lectures on this interesting topic may 
be found in part xviii. of Braithwaite s Retrospect, we trust that 
all who desire to be well informed on obscure points of pathology 
and practice will devote sufficient time to the perusal and study 



420 DIAPHORESIS — DIET. 

of this matter. The experimental details and the inferences based 
on them are so conclusive as to be irresistible and unanswerable. 
Such, at least, is the conviction forced on us, even despite of the 
cherished prepossessions of former years. 

Diaphoretic. — This is from a Greek word, meaning to carry 
through. The idea is that some internal remedy propels fluid 
matter from within to the surface, and we call this superficial 
discharge a perspiration. To maintain a diaphoretic action, it is 
necessary that the patient be in bed, covered quite warm. This 
differs, obviously, from a sweat brought out suddenly in hot 
weather by taking a draught of cold water. 

Diaphoretics have been divided into several grades or orders, 
but all of them depend for their effect on the action they induce 
on the arterial system. This is not less true of the internal 
agents, as essential oils, ethers, camphor, hot teas, and the like, 
than of the external appliances, as vapor-baths, frictions, and 
exercise. 

In common with other means, diaphoretics require a suitable 
state of the system. Every practitioner knows that he cannot 
excite a perspiration on the first day of a high burning fever by 
any sudorific as well as after the action has been reduced by 
blood-letting or vomiting freely. The spiritus mindereri, proba- 
bly one of the very best diaphoretics, will not sweat when the fever 
is at its maximum and no efforts have been made to abate it. 
Draw ten or fifteen ounces of blood, and even that will often in- 
duce a moisture. Give a dose or two of the diaphoretic now, and 
the surface will soon be covered with perspiration. If the general 
system be under the par of healthy excitement, the diaphoretic 
will gently stimulate, and sweat will follow. If much above 
the par, it may augment the excitement, but cannot induce 
sweating. 

Diet. — We have not space to enter fully into this important 
topic ; but, in addition to the remarks given under the head of 
alimentaria, we deem it proper to make the following sugges- 
tions ; and first in importance in this consideration is the regula- 
tion of infantile diet. If the mother enjoy good health, the best 
nourishment for her infant is her own milk, and it is so because 
it is the wise provison made by Heaven, and cannot be improved. 
If she be careful to eat and drink those things only which she 
knows by experience are best suited to her condition, the child 
will thrive and do well. But if the maternal vigor be impaired, 
the digestive functions out of order, and assimilation imperfect, 
the infant will not acquire substantial vigor, even though the 
mother's milk may be in great abundance. Under such circum- 
stances, it may be necessary to change the supply of nutriment. 
This may be essential to the well-being of mother and child ; for 



REGULATION OF DIET. 421 

it would be a vain effort to aim, by a change of diet, to improve 
the mammary secretion, if there be such derangement of the di- 
gestive function as to render impracticable the formation of health- 
ful blood. Yet, by procuring another supply of milk from a per- 
fectly sound frame, it might be practicable to change the essen- 
tial nature of the infant constitution, and thus insure its invigora- 
tion and growth. 

In the absence of a nurse whose breasts can furnish the re- 
quisite supply of salutary nutriment, infants may be raised by 
the use of the sucking-bottle, or by spoon-feeding. Some of the 
finest children I have ever seen have thus been reared, and they 
have grown to maturity in the enjoyment of robust health. In 
all such cases it should be the constant aim to provide the best 
substitude for the natural food (I mean the mother's milk) that 
can be obtained. This is the secret of success. Cow's milk, 
more or less diluted and properly sweetened, arrow-root, tous les 
mois, and the like, have all been resorted to with frequent suc- 
cess, and all occasionally with an opposite result. 

A fundamental rule in all this matter is to observe rigidly the 
law of cleanliness and moderation. Every vessel and implement 
employed in the feeding of infants should be perfectly and alivays 
clean, and every article of food should be sound, fresh, pure, 
and well prepared. For want of attendance to these simple 
items the digestive functions and the assimilative powers of infants 
have been ruined, a scrofulous diathesis has been roused into 
activity, or it has been formed and rapidly developed. Even 
when the utmost cleanliness has been attended to serious evils 
have resulted from overfeeding, an evil whose ultimate tendency 
is almost as deleterious as starvation. 

In reference to the diet of mature age, any one can readily 
understand how certainly and fatally bad food operates, when he 
calls to mind the horrid effects of the potato disease on the popu- 
lation of Ireland. And when, as in that unfortunate country, 
the depressing influence of misfortune in almost every form is 
superadded to a deleterious diet, we are at no loss to solve the 
secret cause of a terrible epidemic. But, in addition to the uni- 
versal prevalence of fatal fevers, the rapid development of incu- 
rable scrofulous disease has followed in the train of similar causes. 
Many cases of this kind have occurred in families whose sensitive 
feelings induced them to shrink from public observation when 
calamities overtook and prostrated them. The tone of their 
general health first gave way, and then local disease was excited 
from trivial causes. 

The power of modifying adult constitutions by suitable change 
of diet and general living is as certain and real as we ever find 
it to be in infants. Who does not acknowledge this to be true in 



422 THE PHILOSOPHY OF DIET. 

regard to scurvy, a disease of blood-deterioration originally, and 
curable by changing the quality of this vital fluid ? 

The law which regulates the change here is equally applicable 
to a thousand cases ; and its due importance in the management 
of physical education is inconceivably great. "This has been 
well exemplified in the art of training, where diet and exercise 
are reduced to a practical science for the attainment of certain 
results, and with remarkable success. In the hands of a trainer 
the almost breathless and oppressed frame of a person over- 
burdened with lymph and fat speedily becomes converted into an 
active, firm, and well-conditioned organization, exhibiting a 
promptitude of action both of mind and body the direct oppo- 
site of its former manifestations; and if such a change can be 
effected by rigid adherence to rules, in the course of two or three 
months, we may easily conceive the degree of improvement which 
would follow the uniform observance of proper regimen and die- 
tetic precepts in ordinary society." (Combe, On Digestion.) 

Without pretending to enter very minutely into the philosophy 
of diet, let every one bear in mind that a very small amount of 
observation and reflection will suffice to teach what articles of 
food agree best with the stomach and whole system. It is the 
violation of the dictates of nature on this very point that en- 
genders three-fourths of all our diseases. We learn with ease 
the right and salutary lesson, but we act as though it had never 
been studied and understood. If our food fail to oppress or dis- 
turb us in any way, if we feel invigorated and refreshed by it, 
we are warranted in the conclusion that it is safe and proper, no 
matter by what name it may be called. But if, though taken in 
moderation, we realize in a few hours after our meals a distress- 
ing or even unpleasant languor, we may rest assured that the 
food, however much esteemed by many as light and very digest- 
ible, is not the right aliment for our nature. " One man's meat 
may be another's poison." These remarks apply with equal 
force to drinks and luxuries, to dress, and nearly all our habits. 

The diet of the sick includes not merely articles of food that 
are positively proper, but it enters into varied details touching 
the modes of preparation, the quantity to be eaten at a time, and 
the most suitable hours of the day for this end. It points also 
to articles that are decidedly improper, or only relatively so, 
keeping in view at the same time those changes in the human 
constitution in virtue of which things once disagreeable or inju- 
rious become innoxious and even salutary. These things are 
susceptible of vast modification and amplification too, calling for 
large experience and tact in order to do full justice to the sub- 
ject. There can be no reasonable doubt that the success of one 
of the most barefaced humbugs of the day depends chiefly on 



DIGITALIS. 423 

the rigid enforcement of dietetic rules carried to such extremes 
often as to intrench on the ridiculous and to extort a smile from 
credulity itself. May not the regular profession of medicine 
once in a great while condescend to take a hint even from the 
hoodwinked devotees of superstition ? 

Digitalis Purpurea. Digitalis. Foxglove. — This is a bi- 
ennial plant, growing in dry, gravelly soils, in the temperate 
regions of Europe. It is now to be met with in many of our 
own gardens, where it is cultivated as an ornamental appendage. 
In June and July its elegant bell-shaped flowers, somewhat in 
form of the finger of a glove, sometimes purple, sometimes 
nearly white, make a pleasing addition to the floral variety. 
Every part of the plant has medicinal properties, but the leaves 
and seeds are preferred. The fresh leaf has a slightly nauseous 
flavor and a bitter taste, and should be collected just as the plant 
is about to flower, care being taken to select the most perfect 
leaves. The process of drying, in order to preserve the color 
and other qualities, is best conducted in a well-aired, dry loft ; 
or if it be desired to employ artificial heat to effect the drying 
more rapidly, the temperature should never exceed 212°. 

The variable doses of digitalis as spoken of in the London 
Lancet for October, 1845, are to be explained only on the ground 
of the defective or augmented medicinal energy, as resulting 
from cultivation, climate, locality, &c, which exert a marked in- 
fluence on many prominent articles taken from the vegetable 
kingdom. It is important that physicians should be aware of 
this fact in the history of active remedies, as it will serve to 
account for the phenomena otherwise unintelligible. 

Yilliers, in the Journal de Medicine for November, 1817, re- 
ports the case of a man affected with humid asthma who took 
by mistake a drachm of powdered digitalis leaves instead of a 
grain. In other words, he took sixty doses at once. Quickly he 
was seized with vomiting, vertigo, and confused vision. Frequent 
and violent efforts to vomit caused some mucus and bilious matter 
to be ejected, followed by great pain in the bowels, which required 
the use of lavements for relief. These symptoms continued at 
intervals through the next day, and the patient was much ex- 
hausted, with the pulse slow and irregular. On the third day the 
vomiting ceased, but the abdominal uneasiness continued. Ano- 
dynes, spices, and stimulating drinks were employed, and recovery 
gradually took place. The man's vision continued to be confused 
for a fortnight, and as soon as the effects of the poison vanished 
the cough and dyspnoea returned. 

In the October number of the Edinburgh Medical and Sur- 
gical Journal for 1839, we have a very interesting but fatal case 
recorded. A child six years old, affected with scarlatina, took 



424 EFFECTS OF DIGITALIS. 

a mixture in the course of the day containing five grains of 
powder of digitalis, and an injection was administered consisting 
of tincture digitalis and tincture of squills, each one ounce. On 
the next day a drachm of the leaves of digitalis was given, in 
form of injection, in three divided portions. This induced colicky 
pains, frequent stools, bilious vomitings, hiccough, faintings, and 
intermittent pulse. These symptoms continued during six days, 
when the abdomen became tympanitic and painful on very slight 
pressure ; the pulse still intermittent, the urine more scanty, and 
anasarca becoming more general. The powders of digitalis were 
resumed, but with no benefit. Several fits occurred which 
threatened to destroy the child ; still the digitalis was continued, 
although it excited constant nausea and vomiting, and at the end 
of about sixteen days death took place. The attending physician 
seemed greatly surprised that so little digitalis should produce 
such effects. But, as the editor of the journal very properly 
observes, " For a child only six years old, less than the one-half 
or one-eighth of the quantity would have been such an overdosing 
as might justly warrant the opinion that the result was due to 
the digitalis alone." 

The opinions of medical men touching the therapeutic powers 
of digitalis have ever been variant ; yet it has been pretty gene- 
rally agreed that it possesses sedative, narcotic, and diuretic pro- 
perties, and that it calls for good judgment and discrimination, 
because of its obvious tendency to cumulate. This feature de- 
mands from the physician a caution to all persons to whom he 
is exhibiting the medicine, for weeks or even days in succession. 
They should be directed to preserve the horizontal position not 
only while taking the article, but for a week, or at least for 
several days, after its discontinuance. Imprudent rising from 
bed, or even sitting in the half-erect posture, has brought on 
syncope with fatal issue in a few moments. This result is sup- 
posed to depend on the deeply-sedative influence exerted on the 
heart and arteries, in virtue of which the power of propelling the 
blood to the brain is so impaired that an erect position cannot 
be tolerated. The pulse changes from forty or fifty to one hun- 
dred and twenty in an instant. 

When by imprudence a partial syncope is induced, the patient 
should be made to resume the horizontal posture at once, and 
take ten, fifteen, or twenty drops of liquid ammonia, or sulphuric 
ether, in a tablespoonful of water, and repeat in fifteen minutes, 
if not relieved. Sinapisms to the wrists and ankles will be pro- 
per at the same time. 

Dr. Beddoes has furnished a case in which opium saved a 
patient from the poisonous action of digitalis. He labored 
under anasarca, and was very feeble. A large quantity of a 



TINCTURES OF DIGITALIS. 425 

strong infusion of digitalis had been taken in mistake. Three 
grains of opium were administered in two doses, and then fifteen 
drops of laudanum every hour, in port wine. (See Medical Facts, 
vol. v. p. 18.) 

The statement just made is abundantly sufficient to prove the 
sedative, and even the narcotic, character of digitalis. Given in 
large doses, it always displays these properties, and the most 
usual manifestations are nausea, fainting, convulsions, purging, 
cold sweats, with fatal termination if relief be not soon obtained. 
It is not difficult to understand why it is that so many pernicious 
consequences have followed the exhibition of this medicine. Its 
injudicious employment has done vast mischief, and no doubt con- 
stitutes the basis of much of its unpopularity. Yet we do not 
doubt that in the hands of discreet, observant men, it has often 
done good. Digitalis has been much employed alone, and also 
in combination, as a diuretic ; and even when so exhibited we 
must not be unmindful of its depressing influence on the arterial 
system already adverted to. The combination hinted at is gene- 
rally with calomel, or squill, or both. When thus employed, 
the powder of the leaf is well rubbed with the other articles, the 
proper division being made into powders or pills as may be most 
desirable. 

The tincture, although highly valued by some, is not the best 
form of administration. The liability to a collection of dregs 
at the bottom of the bottle, and the possibility of these being 
poured out into vials for use, render the tincture a hazardous 
medicine in careless hands. In addition to this, it contains much 
less of the proximate principle, digitaline, than the infusion. 
Some have preferred the ordinary tincture, made by digesting 
four ounces of the best dried leaves in a quart of diluted alcohol 
(that is, equal parts of alcohol and water) for the space of two 
weeks, expressing first and then filtering through paper. The 
dose is from ten to twenty drops three times a day. Others 
have more frequently employed Drake s saturated tincture. The 
name teaches, significantly enough, that this preparation, first 
announced by Dr. Drake, of England, is a very potent article. 
It is made by filling a bottle with the best dried leaves and add- 
ing as much diluted alcohol or brandy as can be poured in. The 
fluid is saturated with the medicinal properties of the plant, and 
is so strong that not more than five drops can be safely given to 
an adult as the first dose. 

The infusion is prepared by adding a drachm of the leaves to 
half a pint of boiling water. Let the mixture remain for half 
an hour, and then strain or filter, adding a few drops of the oil 
of cinnamon, say four or five ; or we may add one drachm of digi- 
talis and two drachms of cinnamon to a half-pint of boiling 

28 



.426 INTERNAL USE OF DIGITALIS. 

water. Digest four hours in a covered vessel, and strain. The 
adult dose is a tablespoonful three times a day, and gradually 
augmented. 

If the powder of the leaf be preferred, supposing the article 
to be fresh and good, a half-grain three times a day, and increased 
by fractional parts daily, will be a proper portion for an adult. 
If either of the above forms be employed, it is proper to con- 
tinue the administration until there is obvious reduction of arte- 
rial excitement, provided we look for the sedative effects, and for 
a manifest increase in the urinary discharge if we prescribe the 
medicine as a diuretic. 

There is an additional therapeutic use named in a foreign jour- 
nal. A quack somewhere in England gave six ounces of a strong 
decoction as a laxative, and killed his patient by a terrible hy- 
percatharsis that ended fatally in twenty-two hours. 

It is possible also for exceedingly large doses to develop ex- 
pectorant qualities. We infer this from a fact stated in the 
Edinburgh Medical and Physical Journal, of an old asthmatic 
who took an ounce at one dose and was cured. The force of the 
extreme dose spent itself on the morbid condition constituting 
the asthma, and no doubt promoted expectoration. An ounce 
would be regarded as a poisonous dose, and no one would venture 
to administer it. Besides this power of existing disease to con- 
trol poisonous action, it is also proper to bear in mind that opium, 
although confessedly a poison, has been successfully employed 
to counteract the deleterious agency of digitalis. (See Medical 
Facts, vols. v. and vi. p. 18.) 

Dr. Glass, of Wirtemberg, has lately given the result of his 
experience in the use of digitalis in delirium tremens, eleven out 
of thirteen cases having recovered under its administration. He 
employed the infusion, and carried it so far as to induce narcot- 
ism, or more properly digitalism. 

The use of digitalis has been obviously beneficial in dropsy 
resulting from obstruction to the cardiac circulation. By sub- 
duing the heart's action it relieves that congestion of the vascu- 
lar system which is the cause of the effusion of serum. But 
being a diuretic also, it may and does relieve the loaded vessels 
by carrying off in the urine some of the water of the blood. — 
Headland' s Action of Medicines, p. 287. 

Junius Hardwicke, Esq., of Rotherham, confesses that he 
once made a sheer experiment with digitalis in a bad case of 
neuralgia that seemed to defy his powers wholly. He resolved 
to administer half-grain doses of digitalis, in form of pill, every 
three hours, and so great was the relief that the man called for 
more pills, and was thus cured. Mr. Hardwicke says he has 
since given the remedy in many cases of spasmodic and rheu- 



EXTERNAL USE OF DIGITALIS. 427 

matic neuralgia in various parts of the body, with success. — 
Braithwaite, p. xxxii. p. 60. 

The external use of digitalis is far more safe than the internal 
administration, and equally salutary, and we beg leave to urge 
this method on all who feel inclined to test the powers of digi- 
talis. A Portuguese physician reports success in the use of 
squills and digitalis endermically , in the treatment of ascites 
and anasarca. He blistered the abdomen and thighs, and on 
the raw surface applied compresses wet with the mixture. The 
dropsy was of the asthenic variety, and the external application 
was preferred on that account. — Medic o-Chirurgical Review , 
April, 1843. 

A writer in the Revue Medicate says he has employed digitalis 
externally, in the treatment of dropsical affections, for more than 
twenty years. He rubbed the infusion or tincture into the ab- 
dominal surface three times a day. Andral, Christison, Trous- 
seau, Bayle, and many others, have commended this practice 
very decidedly. In one or two days the flow of urine was 
obviously increased, and in a week the water was completely 
evacuated. Dr. Joret, in a paper in the Archives Generate for 
1834, speaks emphatically of the diuretic powers of the decoc- 
tion of digitalis applied to the abdomen, in portions of from two 
to four ounces, morning and evening. He says it may be thus 
employed without risk when gastro-enteritis is present. This 
gentleman has paid special attention to the medicinal powers of 
digitalis, and affirms, as has been already announced, that the 
infusion contains more digitaline than the tincture; that the dry 
plant is better than the fresh leaf; that special culture, season, 
climate, &c. greatly vary the strength, so that while a violent 
diarrhoea has followed the use of three grains of the powder, 
thirty-six and even sixty-five grains have been taken with im- 
punity. 

I have only to add that in consequence of early preposses- 
sions, based on observations of its injurious action in the Phila- 
delphia almshouse and in private practice of distinguished physi- 
cians, I have never been an admirer of the medicinal properties 
of foxglove. I have rarely employed it, excepting in hydro- 
thorax, attended with elevated arterial action, and then I com- 
bined it with calomel. Thus : — 

Take of calomel, ^j 5 

Powder of digitalis, ^ss; 

Conserve of roses, enough to make twenty pills. 

One to be taken three times a day, and the quantity of digi- 
talis to be very gradually enlarged, with careful attention all the 
while to the effects on the pulse. 

Digitaline, the active principle of digitalis, is highly praised 



428 PERSIMMON. 

by Dr. Christison, especially in dropsy, associated with disease 
of the heart. He has speedily removed the effusion by its use, 
and thus enabled the patient to return to his usual avocation. 
It acts with more speed than digitalis does, and with greater 
force after the action begins. Sometimes it has induced alarm- 
ing depression by abating the heart's action too much. The dose 
is one-seventy-fifth of a grain three times a day, a very small 
one certainly. But it must be borne in mind that one-tenth of 
a grain will kill a small dog. The dose may be given in a pill 
with mucilage, or conserve of roses, so as to make a grain in 
weight. 

M. Laroche has found the digitaline to control nocturnal semi- 
nal emissions very happily. A very bad case was soon much 
relieved by doses equal to one grain of the powder of digitalis. 
The night after the use of the remedy the emissions ceased for 
the first time. 

Diosma Crenata. (See Buchu.) 

Diospyros Yirginiana. Persimmon. — The bark and fruit 
are the parts of this well-known tree that are employed medi- 
cinally. Familiar as every one is with its appearance and the 
obvious qualities of the ripe and unripe fruit, it would be a waste 
of time to dwell on these points. 

The first notice I remember to have seen of it was in the 
inaugural dissertation of the late Professor Woodhouse, formerly 
of the University of Pennsylvania. His thesis was entitled The 
Chemical and Medicinal Properties of the Persimmon, and was 
printed in 1792. The bark was examined by Dr. W. and found 
to contain tannin and gallic acid, which accounted for its astrin- 
gency. Its medicinal uses were predicated on its astringent 
power, and extended to diarrhoea, hemorrhages, &c. &c. A 
writer in the American Journal of Pharmacy has pointed out a 
difference in the ripe and unripe fruit in respect of astringency. 
The unripe fruit was found to contain tannin, sugar, and a little 
malic acid, while the fully ripe fruit abounds in sugar and malic 
acid, with merely a trace of tannin. This diversity, however, 
was pretty much what many a schoolboy had often realized. 
He well recollects how his mouth was drawn up almost to a 
point when he attempted to eat the half-matured fruit, and equally 
well the grateful qualities of the same fruit in perfection. This 
corrugating or astringent quality is the same, as to its source, 
in all vegetable matter. 

The astringency of the persimmon bark led to its use in pre- 
paring gargles for sore throat with or without ulceration. The 
late Professor Barton, in his Contributions toward a Materia 
Medica of the United States, commends it for this end, and 
names it also as an old remedy for inter mittents, familiar to the 






DISCUTIENTS — DIURETICS. 429 

common people. In a paper of more recent date, published in 
the American Journal of Medical Sciences, by Dr. Mettauer, a 
very intelligent practitioner of Virginia, the medicinal qualities 
of the unripe fruit are well spoken of. The astringency of the 
article led to its exhibition in diarrhoea, hemorrhage, &c, and 
with happy results. The forms of infusion, syrup, and tincture 
are named, a tablespoonful being the usual dose for an adult. 
The same author regards the ripe fruit as possessed of anthel- 
mintic properties. 

Discutients.- — This term refers to all those external applica- 
tions the tendency of which is to remove tumors. They most 
probably effect the end by stimulating the absorbents to more 
vigorous effort. Various poultices and fomentations belong to 
this class. 

Disinfectants. — The word has reference to infection, and 
implies its abatement or removal. Any agent capable of over- 
coming the disagreeable agency of insalubrious exhalations of 
any kind is, properly speaking, a disinfectant. Chlorine and its 
compounds are prominent examples. 

Displacement. — This is a process which secures the activity 
of drugs that are employed in the shape of tinctures and infu- 
sions. The mixtures, solid or fluid, are put into the displacement 
vessel, or percolator, as it is called, which is a kind of funnel, 
furnished with a fine seive, and, generally, with a stop-cock in 
the lower part and a cap or stopper above. The drug in coarse 
powder is mixed with enough of water, or alcohol, or other solv- 
ent, to saturate it completely. This process may be effected, if 
desirable, in a mortar, or in the tight percolator, its stop-cock 
being then closed. The mixture is pressed into the percolator 
— not too forcibly, however, as that might retard the operation 
— and is to remain there from a few minutes to twelve hours. 
When it is intended to draw off the liquid, a further addition of 
fluid is required, the addition being gradually made. The stop- 
cock is now opened and the filtered fluid collected in a suitable 
vessel. Further additions of the menstruum are to be made until 
the prescribed quantity of tincture or infusion is obtained. 

Diuretics. — The Greek word whence this term comes means, 
simply, a discharge of urine. Any agent that increases the flow 
of urine is a diuretic, and hence the range is extensive, embracing 
many articles named in our books of Materia Medica, and some 
that are not. Among the latter we cite certain mental opera- 
tions, as fear, about which every schoolboy and candidate for 
graduation knows something in his own experience. Some 
diuretics appear to act partly as tonics, combining bitterness 
with a quality that leads to a diuretic result. Some act by 
stimulating the kidneys, and these are, of course, improper in a 



430 COWHAGE — ECTROTIC MEDICATION. 

state of high arterial excitement. Very many act chiefly as dilu- 
ents in virtue of the quantity of fluid swallowed, and we may cite 
warm water, or barley water, or gum Arabic water, as in point. 
Others appear to operate by reducing the excitement of the 
whole system, including, of course, the heart and arteries as well 
as the kidneys. The lancet, leeches, the cold dash, and digitalis 
may act in this way. 

It must be obvious from this brief statement that all articles 
called diuretic cannot be alike proper for all sorts of patients, 
and that the discretion of the physician is demanded in order to 
make the proper adaptation. But it is not needful to enlarge 
here, as we shall find frequent opportunity for noticing this sub- 
ject hereafter when we treat of individual diuretics. 

Dolichos Pruriens. Mucuna Pruriens. Cowhage, or 
Cowitch. — This is the down or hair of a plant known in India 
by the name of Jciwach, and long in use there as an anthelmintic. 
The young and tender pods form articles of diet in that country. 
When quite mature, these pods are of a brownish color, and are 
covered with countless sharp, pricking hairs, which keenly irritate 
the skin ; and for this reason their anthelmintic action has been 
called purely mechanical. 

The pods being dipped into honey or molasses, have the hairs 
stripped off until they acquire the consistency of an electuary, 
of which a tablespoonful is an adult dose and a teaspoonful suffi- 
cient for children. It must be soon followed by a purgative, as 
castor oil. 

Dbimys Winteri. Winter s Barh. — This tree was employed 
as a spice in the treatment of scurvy, in Drake's voyage round 
the world in 1759, by Captain Winter, who brought some of it to 
Europe. The tree grows from six to forty feet high. The bark 
is in flattish quills four or five inches long and two inches in 
diameter and a sixth of an inch in thickness. It is smooth ex- 
ternally, of a pale or reddish-yellow color, with red oval spots, 
of an aromatic odor and a warm, pleasant, spicy taste. Its 
properties are due partly to tannin and a pale, warm, pungent, 
volatile oil. Hence it has been used as a substitute for cinna- 
mon and canella bark. It is tonic, stimulant, and aromatic. The 
adult dose may vary from ten grains to a drachm. 

Dutch Liquid. — This is an exceedingly volatile fluid, more 
correctly named the chloride of olefiant gas. On account of its 
high volatility some hold it to be the best of all local anaesthetic 
agents. Its action endures longer than that of other agents, 
and its odor is less disagreeable. From fifteen to thirty drops, 
covered with a moist compress, will suffice to allay pain in most 
cases. 

Ectrotic Medication. — A Greek word, signifying to abort or 



ELATERIUM. 431 

produce abortion, has given us that peculiar form of medicinal 
administration called ectrotic. It is comparatively a new topic 
in medical lectures or in books on Materia Medica. In 1825 
Bretonneau and Serres published an article in the Archives 
Gene rale, on the use of cauterization in smallpox, and called the 
process Methode Ectrotique. The operation was said to cause 
the abortion of the pustules — in other words, to prevent their 
maturity, and eventually to secure the face from scars or pits. 
In place of actual cauterization nitrate of silver was employed, 
sometimes in very strong solution, and often in the solid stick 
form. From fifteen to forty-five grains, dissolved in an ounce of 
water, made a suitable solution, to be applied by a camel' s-hair 
pencil to each eruption. Bretonneau first opened the apex of 
each pustule, and then applied the caustic. Serres affirmed that 
the simple application, without puncture, not only aborted the 
pustules, but averted or abated phrenitis, otitis, ophthalmia, 
&c. &c. Velpeau took off the apex of each pustule with the 
point of a lancet and placed the caustic on the spot. It is 
affirmed that if the operation be performed on the second day 
of the eruption, no perfect pustules are seen, the inflammatory 
action being completely arrested. 

Serres, Chomel, and others, tried the emplastrum de vigo, a 
compound mercurial mixture, in order to obtain a like ectrotic 
result, and with success. A mask is procured, and the plaster 
being spread on its interior surface, is placed on the face. If 
applied on the second day of eruption, it prevents pitting or 
scarring. To test the value of this plaster, trial has been made 
of simple diachylon, but without success. The result is plainly 
independent of the exclusion of the light or air, because the sim- 
plest plaster would accomplish this perfectly. I am aware that 
a Southern practitioner has affirmed that confinement in abso- 
lutely dark apartments will secure the face from pitting, and 
possibly it may be so. 

In the Philadelphia Medical Examiner for August, 1846, we 
are told that cases of smallpox have been happily managed with 
tincture of iodine so as to save the face from deformity. This 
use of iodine grew out of its frequent employment in various 
inflammatory affections in lieu of nitrate of silver, and the well- 
known success of the latter as a means of ectrotic medication in 
France. 

Elaterium. — Inspissated juice of the momordica elaterium, 
or wild or squirting cucumber. As a remedial agent this has 
age to recommend it. The Lexicon Medicum of 1702 defines 
it the " juice of the wild cucumber inspissated and brought to 
a hard consistence." Formerly the term elaterium was applied 



432 ELATEKIUM. 

to every sort of powerful medicine that induced copious watery 
stools. 

Wild cucumber has been cultivated expressly for medicinal 
use. The fruit when fully ripe is somewhat like a small oval 
cucumber, covered with prickles. It falls from the stem, and, 
bursting, throws out its juice, and has hence been called the 
squirting cucumber. The fruit is gathered in September, and 
the juice is gently expressed, strained, and set aside for a few 
hours. A gray sediment falls, which being dried with care, fur- 
nishes a kind of extract. Clutterbuck's elaterium was made by 
selecting the juice that surrounds the seeds and slowly inspis- 
sating it. This species is more energetic than the other, acting 
violently as a cathartic in doses of the eighth of a grain. The 
other variety is administered in half-grain doses. The stools are 
not only frequent and copious, but very watery, and hence the 
article is called a hydragogue cathartic. 

Good elaterium is very light and friable, of a light-gray color, 
and contains a proximate principle of great potency called 
elatin. 

Elaterium was originally exhibited almost exclusively in drop- 
sical affections. Hippocrates and Dioscorides both were familiar 
with it, and especially in this relation. Some of the old physi- 
cians employed every part of the plant as a remedy for dropsy. 
Sydenham and Ferriar exhibited the inspissated juice. 

I have employed it a very few times, and then not satisfac- 
torily. In the case of an officer who had served in Mexico, in 
the army of Iturbide, I pushed it as far as I could, and although 
some present benefit seemed to follow, there was no permanent 
advantage. The man had labored for years under hepatic dis- 
ease, the liver being enlarged and not performing its functions. 
When he came under my notice he had a greatly enlarged abdo- 
men, and assured me that he had taken a great deal of mercury 
to no profit. I gave him the elaterium in doses of a sixteenth 
of a grain three times a day, gradually raised to a quarter of a 
grain. The quantity of fluid evacuations was incredibly large, 
and their frequency alarmed me. He bore the operation pretty 
well, and his abdomen resumed its wonted size, but he was not 
really improved. The belly was quickly distended again, and I 
felt satisfied that an indurated liver and a permanent derange- 
ment in the equilibrium of the circulation precluded the prac- 
ticability of restoration. The local action of the cathartic was 
tried often enough to satisfy me that its effects were only tran- 
sient. 

It is reported that some cases of chorea have been signally 
benefited by the use of elaterium ; and when active purging is 
really demanded the remedy may answer, although I would be 



ELECTRICITY. 433 

slow to make trial of it. The mode of exhibition was as fol 
lows : — 

]£. — Powder of jalap, thirty-six grains ; 
Powder of elaterium, one grain ; 
Powder of ginger, twenty-four grains. 

Mix, and divide into twelve powders. One to be taken every four hours, until 
the bowels are freely evacuated. 

Some physicians, fearful of the violent operation of elaterium 
given by the mouth, have preferred to use it in form of supposi- 
tory, made by mixing one or two grains with soap and then 
passing the mass up the rectum. Irritation soon ensues, spreads 
to the whole canal, and copious evacuations follow. 

The elatin before named makes about one-half of the elaterium 
by weight. It is separated by digesting elaterium in alcohol by 
a slow heat for twenty-four hours and filtering the solution. The 
residuum should be washed several times with pure alcohol ; and 
the solutions so obtained, on being evaporated, yield a solid green 
substance. This is to be boiled in pure water, which dissolves a 
part and leaves a portion undissolved, which is the elatin. This 
product is nearly tasteless, greenish, insoluble in water, soluble 
in alcohol, inflammable, and emitting while burning an aromatic 
odor. Elatin is also separated by the agency of sulphuric ether. 
One grain of the pure article dissolved in ninety-six drops of 
pure alcohol gives a tincture a drop of which acts violently on 
the bowels. It is quite too potent for safety. 

Electricity. — This is a very ancient remedy, sometimes bene- 
ficial, but oftener exerting a mischievous influence. Nor is it 
difficult to account for the preponderance of evil over the good 
that has been accomplished by this agency. The right and safe 
application requires much more knowledge than appertains to 
the mere electrician. A man may be able to construct a beauti- 
ful and powerful machine and to display electrical phenomena 
very happily, and yet he may be a minister of ills without num- 
ber to those who place their systems in his power. The electri- 
cian who would not injure his employers must have a pretty 
extensive acquaintance with disease, with constitutional pecu- 
liarities, with temperaments ; with physiology, pathology, and 
anatomy as the basis of both. And in addition to these acquire- 
ments, it is important that he be not a novice when he undertakes 
to treat dubious cases. 

From what has been said it must be quite obvious that the 
mere mechanical electrician must do more harm than good, and 
when he realizes the latter it may be fairly attributed to mere 
accidental or providential interference. 

He who would make a right use of electricity must know what 
affections may be the better for its agency, as well as those whose 



434 MEDICAL USES OF ELECTRICITY. 

aggravation must ensue as a necessary result. He must be aware 
that disorders growing out of defective energy or exhaustion, 
and not those that flow from positive irritation and oppression, 
are most likely to be relieved and cured by electricity ; that it is 
specially applicable to torpor of the vital functions, causing dimi- 
nution of nervous and muscular action no matter how induced. 
High arterial excitement, whether local or general, forbids elec- 
trical operations, while apathy and depression may demand their 
aid. It is vastly important to decide accurately whether organic 
derangement does or does not exist ere resort be had to this 
agent. This is obviously true in respect of blindness and deaf- 
ness more or less complete. These may depend on compression 
or actual disease of the nervous structure, or simply on a lack of 
nervous energy. In the one case an obstacle prevents the right 
functional development, and will do so as long as it remains. In 
the other there is no hinderance to the function, and mere feeble- 
ness is the secret. Here are states very nearly opposite ; and while 
the one might be much improved the other would probably be 
made worse by the same appliance. Hence the vast importance 
of being able to determine whether the ear or eye is or is not 
structurally at fault. If such be the fact, electricity can do no 
good, but may do much harm. If the function of the organ be 
the only matter at fault, its debility may be removed by the mo- 
derate use of electricity, which may act as a gentle stimulant 
and tonic. Of these important distinctions the common strolling 
electrician is ignorant, and he employs his machine simply be- 
cause a man is blind or deaf and fancies he can be relieved. 

What are usually called diseases of the nervous system have 
frequently been relieved by the aid of electricity, and hence the 
common use of the remedy by paralytic persons. Whenever 
benefit has followed the administration in such cases, it is clear 
that there was only a defect of nervous power in the palsied part, 
and a total absence of organic lesion that could control or arrest 
the right action of the brain and nervous system. 

It may be important to decide, before we resort to electricity, 
whether the disease or affection be primary or secondary. If it 
be purely sympathetic or secondary, there will be little prospect 
of good from a trial of the remedy. If the primary state de- 
pend on excess of energy, electricity must be pernicious, unless 
preceded by proper evacuations. 

In almost all cases in which tonics are proper electricity may 
be useful. In scrofula with debility, calling for tonic treatment, 
electricity has often been a good adjuvant, removing obstructions 
of the glandular and lymphatic system, effecting resolution of in- 
durated glands, &c. &c. In the deep depression of the vital 
forces met with in low fevers, electricity is a dangerous agent. 



MEDICAL USES OF GALVANISM. 435 

The suddenness of its operation may extinguish the flickering 
taper in a moment. 

Our remarks thus far have reference to common electricity, 
and we propose to say a few words in the next place on galvanic 
electricity. 

It is not necessary to give any directions for the making of 
galvanic machines, as they are now to be had in every city in 
very neat and portable forms, most happily suited to the pur- 
poses of the medical practitioner. 

To show the importance of this means of cure and mitigation 
we propose to make a few references to the medical inquiries of 
Dr. Philip, in which an ingenious effort is made to prove that the 
galvanic fluid is really, or may be made a substitute for, the nerv- 
ous fluid. We are not unapprized of various efforts that have 
been made to nullify the results which this gentleman reached 
after a long course of patient investigation ; and we know, too, 
that these efforts were abortive. We have paid enough attention 
to the subject to be assured that the conclusions of Dr. Philip 
are legitimate. He fed rabbits with parsley, and after the lapse 
of some hours divided the par vagum, or eighth pair of nerves, 
which furnish the supply of nervous power to the stomach and 
lungs. As a consequence, respiration ceased or became exceed- 
ingly laborious, nausea, with efforts to vomit, supervened, and the 
animals died by suffocation. The stomach having been opened, 
the parsley was found to be unaltered, not in the smallest degree 
digested. Similar experiments were made with other rabbits fed 
in the same manner, but acted on by galvanic currents sent to 
the stomach by the application of one pole of a small pile to tin- 
foil rolled around the end of the divided nerves, the other pole 
being applied to a disc of silver on the epigastrium. In these 
cases the dyspnoea and inclination to vomit did not occur. After 
the lapse of twenty-six hours the rabbits were killed and the 
parsley was found to be almost entirely digested. What could 
be more conclusive than experiments like these, frequently made, 
and always with the same results ? 

Dr. Philip was induced, as a consequence of the experiments 
named, to apply galvanism to relieve and cure asthma, dyspnoea, 
indigestion, &c. &c, aware that these maladies were often set 
up by a deficiency of the nervous energy. He hoped to be able 
to compensate for this defect by the use of galvanism as a sub- 
stitute. He had reached the conclusion that this agent, if not 
actually identical with the nervous power, could be made to per- 
form its usual functions when that power was greatly deficient. 
He maintained its competency to assist the nerves of organic 
life, but did not believe it capable of aiding the nerves of volition. 
A late writer in the 3Iedical Gazette of London (Grantham) 



436 MEDICAL USES OF GALVANISM. 

contends for the actual identity of the galvanic fluid with the 
vital action of the nerves of volition as well as those of organic 
life. 

The practical applications of galvanism by Dr. Philip were 
successful not only in his own practice, but in the hands of others. 
The deranged conditions of the lungs and stomach included in 
the terms asthma, dyspnoea, and indigestion, were most happily 
relieved and cured by this instrumentality. I have known the 
most simple form of galvanic arrangement (so simple, indeed, 
that some have denied its power altogether) to relieve a very dis- 
tressing asthma of long standing. The patient was under the 
care of the late Professor Eberle, in Cincinnati, and the contri- 
vance consisted of a metallic wire thrown over the left shoulder, 
at either end of which was a small metallic plate that remained 
constantly next to the skin and hanging down so that the ante- 
rior plate might be as near as possible to the heart. 

I do not say that the confidence inspired in the patient's mind 
by the assurances of his physician did not contribute to the re- 
sult, but I am very sure that the doctor relied much on the feeble 
galvanic arrangement. 

Doubtless the medical uses of galvanism grew out of its re- 
semblance to common electricity, which had long before been 
made subservient to the wants of the profession ; and as they 
are modifications of a common agent it has happened that their 
applications have been successfully made to the same forms of 
morbid action. The administration of galvanism is to be con- 
ducted on the principles marked out for the use of ordinary 
electricity in every respect, and thus guided, both will prove 
safe. 

These agents have been employed with great success in cases 
of opiate poisoning. Whether the results depended on actual 
decomposition of the opiate or on such stimulus to the nervous 
system as saved it from the shock inflicted it is not needful to in- 
quire. The issue is the matter of greatest moment. 

We have spoken generally of the efficacy of the agent in 
nervous diseases, but feel it our duty to give briefly the facts of 
a case of aphonia of long standing cured permanently by gal- 
vanism. This disease, marked by a partial or entire loss of voice, 
is frequently associated with defective nervous energy of the or- 
gans of voice, and hence the propriety of the remedy. 

The report states that the galvanic circuit was completed by 
putting a silver piece on the tongue and touching it with the 
negative wire of a galvanic battery whose other wire was alter- 
nately connected with and separated from different parts of the 
external larynx. In this way shocks were repeatedly sent to the 



MESMERISM. 437 

nerves of the organs concerned in the formation of the voice. 
(See American Medical Journal, Oct. 1847.) 

The same agent has also been employed as a promoter of 
uterine contraction in Great Britain, and also in this country. 
Dr. Radford and others, in Edinburgh, have resorted to it as an 
accelerator of parturition in cases of topor of the uterus ; and 
also as a means for arresting uterine hemorrhage, by inducing 
prompt and efficient uterine contractions. A writer in the New 
Orleans Medical Journal, July, 1846, has furnished testimony 
to the same point. 

In Bell's Select Medical Library, volume third, may be seen 
a good deal of testimony to show the efficacy of electricity and 
galvanism in asthma, dyspepsia, palsy, epilepsy, &c, to which 
work we refer our readers. 

The last therapeutic use of galvanic electricity to be named 
refers to its escharotic power. This is not generally known to 
the profession, and yet is too important to be withheld. M. Pra- 
vaz, in the Revue Medicale for 1830, furnishes the following 
statement touching the management of the bites of rabid animals. 
He applied the wires of a common pile to the bitten part, within 
a quarter of an inch of each other, occasionally moving the wires 
over the spot. The animal fluids were speedily coagulated and 
the poison modified, or its action arrested. A pile of forty or 
fifty pairs will produce an escharotic effect fully equal to that 
from a solution of five grains of nitrate of silver in an ounce of 
water. The stronger the battery the more intense will be the 
escharotic action. And it is believed that the remedy may be 
usefully applied to old and indolent ulcers. 

Electricity, in all its forms, has been resorted to in the hope 
of restoring persons apparently dead by drowning. And it is 
believed that at no distant day there may be such a wise use of 
the agency in suitable cases as to insure success. During my 
pupilage I assisted in numerous experiments made by my pre- 
ceptor, the late Dr. Parrish, on dogs that were drowned in the 
pneumatic tub. As soon as they could be removed to a table, 
the galvanic battery, consisting of the ordinary pile, was brought 
to bear upon them with marked effect. One wire was passed into 
the mouth, the other into the rectum, and the spasmodic contrac- 
tions, the opening of the eyes and jaws, seemed to be certain in- 
dications of restoration. But the desired end, viz., actual resus- 
citation, could not be attained. 

It may be expected by some that a considerable space would 
be allotted to the vaunted miracles of animal electricity or ani- 
mal magnetism, or mesmerism. But the vagaries of this subject 
are so perfectly in keeping with the stale tricks and illusions of 
jugglery that I cannot regard them as entitled to a serious notice. 



438 ELIMINATION. 

There may be, and probably is, some truth mingled with the 
huge mass of delusion and falsehood ; and the same might, with 
a show of propriety, be affirmed of the devil, albeit his accredited 
title is the father of lies. The developments of the mesmeric 
philosophy have been marked by a periodicity of type, coming 
and going by fits and starts, as the interest of the operatives 
prompted ; and they are destined to annihilation as they come 
in contact with cultivated minds and vigorous common sense. We 
cannot close these remarks better than by giving the following 
quotation from an article by Dr. Wigan, (author of Duality of the 
Mind,) in the London Lancet for 1845. " The treadmill is the 
only cure for mesmerism, at least of those who make it a means 
of extracting money from their dupes ; as for the poor creatures 
who pursue the ' science' as amateurs, they must be left to them- 
selves. We can prevent gaming-houses, but we cannot prevent 
domestic gambling. At any rate, while such exhibitions are 
tolerated, it is a shameful injustice to punish old women for 
giving poor servant girls delightful dreams by prophesying hand- 
some and wealthy husbands, and taking their half-crowns in ex- 
change for the cheap bliss." 

Elimination. — The London Medical G-azette for 1844 con- 
tains a valuable paper by Dr. Bentley Todd oil the treatment of 
acute rheumatism, in which he strongly advocates what is called 
the treatment by elimination, and called also the eliminating 
practice. 

This, like the depurative system recently advocated by Gold- 
ing Bird, is a virtual and practical enforcement of the doctrine 
of the humoral pathology. We have long taught this very doc- 
trine of elimination as vastly important, though not under the 
same phraseology. That it is strictly correct and founded on the 
laws of the human system we have not a doubt. The sooner it 
is universally recognized the better. 

Elimination means neither more nor less than the conveyance 
of morbid matter out of the body through the various emunc- 
tories or outlets. It is based on the simplest pathology, viz., 
that disease is often caused by some sort of morbific matter in 
the blood which may be carried out of the body. Rheumatism 
is taken as an appropriate example, whose materies morbi is held 
to be lithic acid, and its natural outlet by the skin. Many 
chemists affirm that it will escape also by the kidneys ; and that 
as vitiated digestion increases its quantity in the stomach and 
bowels, part of it may be carried off through the alimentary 
canal. The indications are, therefore, to promote the action of 
the skin, the kidneys, and the bowels ; to use antacids, to give 
large quantities of fluids in order to dilute the materies morbi 
abundantly, and so to aid in the drainage effected by diaphoresis 



EMETICS. 439 

and diuresis. Such is the simple process by which the elimina- 
tion of morbid matter is proposed to be effected. 

Any medicine which is naturally eliminated would act as an 
eliminative medicine. Thus, if a drachm of urea be dissolved 
in water and injected into the veins of a dog, it causes copious 
urination, which continues till the whole is excreted. Lactic acid 
is diaphoretic. In rheumatism the sweat is largely increased, 
because an excess of lactic acid is formed in the blood. These 
instances well illustrate the point. 

By reference to the article depuration it will be seen that Dr. 
Todd and Dr. Bird have substantially the same views of pathology, 
and hence the similarity of their practical directions. The sub- 
ject is too important not to gain the special attention of medical 
men. We regret that we have not room for a fuller notice of 
this very interesting topic. 

Emetic Tartar. (See Antimonium.) 

Emetics. — This term refers to any and every agent capable of 
dislodging the contents of the stomach, and consequently em- 
braces some things that are not, strictly speaking, medicinal — 
as offensive sights, smells, tastes, disgusting recitals, the mere 
talk about taking a dose of physic. 

It is important just here to inquire whether vomiting is op- 
posed to nature in such a sense as to justify the infinitesimal 
practitioners in refusing to administer emetics in croup — in other 
language, to ascertain whether the remedy is not so explicitly 
urged by nature herself as to make its utter neglect criminal. 
And here it is only necessary to appeal to the history of infancy 
in all countries in order to reach the conclusion beyond the possi- 
bility of mistake, that some vomiting is indispensable to infantile 
existence and thriving. To control a sucking child in regard to 
the quantity of milk drawn from the maternal fount is often, 
very generally, indeed, impracticable. In ten thousand instances 
it cannot be done. What then ? the stomach is overloaded, and 
the surplus cannot find egress by the bowels. Nature meets the 
difficulty, and evacuates the stomach or throws off as much as 
the emergency calls for. This process is repeated twenty times 
a day in the first year of life, and yet the most vigorous consti- 
tutions are the result of all this, or of something else. At all 
events the repetitious vomiting, twenty times a day for months, 
does not prevent the development of perfect vigor, and this re- 
iterated evacuation of the child's stomach is a thing that every 
mother looks for, and which, therefore, occasions no alarm. In- 
deed, you will often hear experienced females assert that the in- 
fants who throw up almost as fast as they suck, and then take 
the breast with avidity, with the certainty almost of throwing up 



440 PHILOSOPHY OF VOMITING. 

again, are among the most vigorous children that are raised to 
maturity; and such is the fact. 

If these things be so, (and the testimony of the civilized world 
says they are,) how can emetics be rejected in those diseases of 
young children which in thousands of instances have been 
promptly relieved by them, on the naked assumption, made in 
the very face of nature, that such remedies are unnatural and 
therefore hurtful ? Shall we heed the voice of nature, or the 
mysticism of the infinitesimal practice ? Judge ye. The practi- 
tioner, call him what you may, is not fit to take the charge of a 
case of inflammatory croup, threatening instant suffocation, if 
he is so wedded to his infatuation as to withold a prompt emetic 
because " it is a means at war with nature." The premises are 
false, and the conclusions cannot be true. There never was and 
never can be an infinitesimal dose exhibited that is the one- 
thousandth part as safe, while it is less than a millionth part as 
salutary, as the prompt emetic given to a child laboring under 
inflammatory croup, after due local or general bleeding has been 
premised. The writer has had twenty cases of croup in his 
own family, at least, and all with happy termination ; nor has 
he ever lost a patient with that disease to this day, and yet 
his reliance has been chiefly on emetics. Of all the classes in 
Materia Medica not one is so safe, so easily tolerated by infantile 
constitutions, as emetics, and it is so because nature has made it 
thus. 

In quite young subjects vomiting takes place so spontaneously, 
to appearance, as to occasion very little disquiet. Not so in 
more advanced life, except in rare instances. For the most 
part the act of vomiting is preceded by uneasy sensations, con- 
sisting of various degrees of nausea, and this augmenting until 
the full effect occurs. Before the emetic development is complete 
the face becomes pale, the pulse flags, the spirits are depressed, 
there is anxiety, listlessness, and a tendency to faint. Presently 
a sweat breaks out, which affords relief; but if the vomiting be 
severe, there will be pain or uneasiness about the clavicles. 
Such are some of the attendants on the act of vomiting. The 
relaxation of the whole system often has the effect of arresting 
morbid action, and the copious perspiration that ensues often 
contributes to this result. 

The mere emptying of the stomach is only a physiological 
effect that in itself has no necessary bearing on the cure of 
disease. It is the therapeutical result, or that which grows out 
of the fact that other and even distant parts feel the force of the 
local action in the stomach, which gives so much importance to 
this class of remedies. Hence we cure a severe headache sim- 



PHILOSOPHY OF VOMITING. 441 

ply by a mild emetic, and without any application directly to 
the head. 

It has been supposed by some that emetics operate by their 
local stimulation of the coats of the stomach. Such may be 
the fact, though not in every instance. Sometimes a consider- 
able lapse of time occurs between the taking of an emetic dose 
and the beginning of its action, much longer indeed than would 
seem necessary for a purely local impulse. Hence the inference 
that emetics generally enter the circulation prior to the vomit- 
ive development. Tartar emetic introduced into a vein will 
vomit in a shorter space of time than if it be swallowed. Ma- 
gendie proved that when emetics havs caused vomiting the 
effect may be arrested by pressure on the medulla oblongata, 
just as the convulsion induced by strychnia may be checked 
by pressure on the motor tracts of the spinal marrow. The 
inference thence deduced was that the action of emetics does 
not depend on local stimulus of the gastric nerves, but on the 
agency of the emetic after entering the circulation, as an indi- 
rect stimulus to the origin of these nerves, whereby contractions 
of the stomach and of the abdominal and other muscles are 
secured. These nerves comprehend a branch of the eighth 
pair, the intercostal and phrenic. 

Notwithstanding all this, vomiting does sometimes follow a 
direct impression on the nerves of the oesophagus and stomach. 
A feather and other mechanical contrivances act in this man- 
ner, for the effect is immediate. The sailor's emetic is of the 
same nature. 

An irritant in the structure of the stomach, caused by dis- 
ease, will so interfere with the proper functions of the organ as 
to induce frequent vomiting. It may operate like a foreign 
body thrust against the walls of the stomach, proving a mere 
irritant, though a perpetual one. Tumors pressing on the py- 
lorus, thickening of a portion of the walls of the stomach, are 
cases in point. The latter may be often very obscure, and 
hinder a correct diagnosis. Such a case fell under my notice 
in the person of a robust farmer of excellent habits. Irrita- 
bility of stomach, and then frequent vomiting, the rejection of 
solids and fluids, and mental depression as a consequence, made 
out an embarrassing case. Enlargement and scirrhus of the 
liver were suspected, and appropriate remedies resorted to, 
but in vain. Dissection showed a thickening of the anterior 
wall of the stomach, with a base not less than two and a half 
inches in diameter, tapering to a point, with a thickness of tex- 
ture amounting nearly to an inch and a half. This constituted 
the entire pathological state of the patient, and was the exclu- 
sive source of his gastric distress. 
S 29 



442 ACTION OF EMETICS. 

Whatever be the cause of vomiting, there is indispensable to 
its full display a certain action of the stomach and certain 
muscles of the abdomen and thorax. Some prominent French 
and English physicians have contended that the stomach is 
wholly passive, that vomiting is effected by the action of the 
diaphragm and abdominal muscles exclusively. Some reject the 
agency of the abdominal muscles and make the diaphragm the 
principal agent. Dr. M. Hall designates vomiting a kind of 
violent expiratory effort, not unlike the act of coughing, which 
often excites vomiting in delicate persons. We see no good rea- 
son to doubt that the muscular coat of the stomach performs its 
part, and favors the process by due contraction. Whatever be 
the muscular force employed, it is clear that the nervous system 
is deeply implicated. If the nervous energy be suspended, as 
in profound intoxication, it is not easy to excite vomiting. But 
if the intoxication be partial, the nervous excitement actually 
augmented, vomiting will often come on spontaneously, or it 
may be induced without difficulty. 

The length of time requisite for the proper action of emetics 
is various. Some act very speedily, and are hence called prompt. 
As instances, we cite the sulphate of copper and the sulphate 
of zinc, both being employed in cases of poisoning on account 
of the celerity of their action. The slow emetics include such 
as are obtained from the vegetable kingdom; a fair specimen is 
found in ipecacuanha, which not unfrequently requires from 
thirty to forty-five minutes for action. There is something, also, 
in diversity of the same constitution at different times, to explain, 
if we knew it precisely, why the length of time varies so much 
and so frequently. Persons of a torpid habit are operated on 
slowly, and require large doses as a general rule. Females are 
more readily vomited than males, and children than adults, be- 
cause of the greater laxity and yielding nature of their fibres. 

Emetics are to be considered as unsafe for persons disposed to 
apoplectic attacks, because the vomitive efforts increase cerebral 
determination. They induce a temporary interruption of the 
pulmonary circulation, prevent the return of blood from the head, 
and so set up or increase liability to congestion. And yet apo- 
plexy has been prevented and relieved by emptying the stomach. 
Over fullness, or the presence of offending matters in the stomach, 
may be an occasion of apoplectic seizure, and then the sooner 
the offending cause is dislodged the better. 

Emetics are also unsafe for persons, laboring under hernia or 
prolapsus of any kind, as well, as for females in advanced stages 
of pregnancy. And yet there are women who, from mere habit, 
take emetics at all times, and with no bad result. 

The proper time for taking emetics is worthy of a passing 



EMMENAGOGUES. 443 

remark. As a general rule, the evening will be found to be the 
best time, provided there is no urgent reason for taking them 
sooner. There is a natural propensity to repose as the day de- 
clines, and this bent of our nature is gratified by deferring the 
exhibition until seven or eight o'clock at night. 

The protracted action of emetics is occasionally embarrass- 
ing. They do not cease to evacuate and irritate when we desire 
them to do so. The case may be alarming, and sometimes puts 
all our efforts at defiance. Perhaps a solution of Epsom salt 
may serve our purpose, by turning the irritation downward. A 
tea-spoonful of common house salt in a teacup half full of water 
has answered the purpose. Or a little old wine, or a few drops of 
laudanum, or a teaspoonful of brandy, may suffice. The bowels 
should be opened in all cases, and if the above-named expedients 
fail, make a blister on the epigastrium of the size of a dollar 
by the use of boiling water or concentrated ammonia, and to the 
raw skin apply a half-grain of a salt of morphia, to be repeated 
in half an hour if necessary. A half-drop or whole drop of 
creosote given every half hour has sometimes succeeded. 

The application of emetics in the treatment of disease is very 
extensive and of great value. We shall have frequent occasion 
to refer to this hereafter, as we have done heretofore. 

Emetin. (See Ipecacuanha.) 

Emeto-Catharttc. — The term sufficiently explains itself. A 
mixture of calomel and ipecacuanha is very often of great value, 
because of the twofold results to which it gives rise, viz., vomit- 
ing and purging. 

Emmenagogues. — This term comes from two Greek words the 
import of which is to move the menses. A question has been 
raised here that has not, perhaps, been definitely settled. Is 
there any medicine or agent capable of exerting direct power 
to move the menses ? If it be true that the catamenia come 
originally from the ovaries, the question may be even more 
embarrassed; under any circumstances it is a difficult one. If 
all real emmenagogues be ovario-spinal excitants, then it is more 
than probable that they are all indirect agents. 

It is very certain that means of the most opposite qualities 
have been the accredited agents in the rectification of catamenial 
derangements; and we are forced to infer that all do not act 
alike, just as we know that the constitutions acted upon are dis- 
similar. General and local bleeding, purging, vomiting, absti- 
nence, tonics, antispasmodics, the mildest as well as irritant 
articles, have all been apparently successful. 

The facts teach the vast importance of prescribing medicine 
or means of any kind for the relief of menstrual irregularities 
with special reference to the peculiarities of each case, and not 



444 



EMULSIONS — ENDERMIC MEDICATION. 



to be governed by the reputation assigned to any remedy, how- 
ever strong the testimony may be in its favor. 

Emulsions. — These are defined to be soft and oleaginous mix- 
tures, not unlike new milk. They present some compounds that 



are frequently available in practice, 
suffice 



The following samples may 



Camphorated Emulsions. 






Pectoral Emulsions. 


1. R. — 01. amygdal. dulc. gss; 


1. 


R- 


—Spermaceti, ^i ; 


Pulv. gum Arab. q.s. 






Pulv. gum Arab, gij ; 


Camphorse, grs. x. 






01. amygd. dulc. ^i ; 


Rub these well together, and add 






Syr. simp. 


Aq. cinnam. ^iv; 






Syr. tolutan. aa gss ; 


Syr. limon. t ^ss. 






Aq. rosar. ^iv. 


Mix. 


Mix. 




2. R. — Amygdal. dulc. ^ss ; 


2. 


R- 


—01. aymgd. dulc. ^iss 


Amygdal. amar. gss ; 






Vitelli ovi i ; 


Aquae, ^viij ; 






Muc. gum Arab. J;ss : 


Pulv. gum Arab, gij ; 






Vin. ipecac, giss ; 


Camphorae, J}i. 






Syr. scill. gss ; 


Mix, to make an emulsion. 






Aq. foenic. d. giy ; 


Dose, a tablespoonful once every 


Mix. 




three hours. 


3. 


R- 


— Muc. gum Arab, ^i; 


3. R. — Camphorae, 






Morph. acet. gr. i; 


Potass, nit. aa ^i ; 






01. amygd. dulc. 


Pulv. gum Arab, gi ; 






Syrup tolut. aa ^ss ; 


01. limon. ^i ; 






Camphorae, grs. v ; 


Aquae, gviij. 






Aquae rosar. t ^iij. 


Mix. 


Mix. 





Endermic Medication. — The definition given of this term 
in some of the medical dictionaries is incorrect, and has led to 
false apprehensions of the value of the practice. It is said to 
be "that mode of using medicines in which they are rubbed into 
the shin y especially after the cuticle has been removed by a 
blister. The words italicized are exceptionable. They lead to 
the impression that the mere friction of medicines on the sound 
surface constitutes endermic medication. It does not, and is 
only the old-fashioned Iatraleptic treatment. Endermic medi- 
cation demands the previous separation of the cuticle; and for 
want of this precaution the plan of treatment has been laid 
aside by many as of little value. The design of this removal 
of the entire cuticle from the blistered spot is to present an 
absorbing surface, and thus insure a result that mere friction 
on the sound skin cannot accomplish. One of the fullest papers 
on this subject was published by Dr. Gerhard, in the North 
American Medical and Surgical Journal, vols. ix. and x. 

I have tried this plan so frequently and with such uniform 
success that I cannot but commend it to such of the profession 
as have not given it a fair trial. It is among our best means for 



ENDERMIC MEDICATION — ERRHINES. 445 

speedily quieting irritability of the stomach and general irrita- 
tion, when it is difficult or impracticable to administer the proper 
remedies by the mouth. 

In cancer uteri, when large doses of opium have ceased to re- 
lieve, the spasms have been greatly mitigated by passing a seton 
through the soft parts in the vicinity, coated with cerate contain- 
ing two or three grains of acetate of morphia. The repetition 
of this appliance daily, or several times a day, has prolonged life 
and made it comparatively pleasant. Here, the endermic principle 
was fully carried out. In chronic rheumatism in any and every 
part of the system, the same plan has been successful. The 
painful part must be blistered, and the cuticle removed to such 
an extent as to allow of the introduction of the salt of morphia. 
Speedy relief is obtained in a few hours, and may be continued 
by a repetition of the dose to the raw surface. In the Retrospect 
of Braithwaite, part xiii., may be seen decided testimony to the 
same point. The London Lancet for September, 1846, speaks 
in high terms of the endermic use of the acetate of morphia for 
the relief of neuralgic fains in various parts of the body. 
Asthma has been promptly relieved, in a French hospital, by the 
same use of the acetate of morphia to the chest. And there is 
sufficient evidence to show that the endermic application of the 
salts of morphia and extract of belladonna to the raw spine will 
do more for the relief of patients affected with delirium tremens, 
tetanus, and hydrophobia, than any other external applications. 

Nervous headache of obstinate and distressing character has 
often yielded speedily to the salts of morphia laid on the temple, 
from which the cuticle has been detached. A half-grain, re- 
peated twice or thrice a day, will generally suffice. The most 
delicate mode for endermic medication is effected by the intro- 
duction of a sharp thumb-lancet, armed with a solution of the 
acetate of morphia, under the cuticle, as in vaccination. To in- 
sure the result, it is proper to make several punctures of the 
skin. In a chronic case of neuralgic rheumatism of the inferior 
extremities, with intense suffering, I advised the insertion of the 
morphia salt in the same way, and with most happy con- 
sequences. 

Sulphate of quinine, digitalis, aloes, iodine, and many other 
articles, can be employed in the same way. 

Enemata. (See Clysters.) 

Epispastics. — Any application capable of inflaming the skin 
and causing an effusion of serum under the cuticle is an epi- 
spastic. Various articles possess this property, which is displayed 
especially by cantharides, to which article the reader is referred. 

Ergot. (See Secale Cornutum.) 

Errhines. — Derived from two Greek words, importing, in the 



446 ETHER. 

nose. Errhines refer to articles which, applied to the lining 
membrane of the nose, excite sneezing, and augment the secretion. 

Ether. — The mutual reaction of an acid and alcohol gives 
rise to an ethereal product, and it follows that the chief differ- 
ence in ethers is owing to the difference in the acid employed. 
Hence sulphuric, nitric, hydrochloric, acetic, phosphoric ethers 
have peculiar qualities belonging to each. The chloric ether, in 
the formation of which chloride of lime supplies the place of an 
acid, is a different article in some respects from all other ethers. 
Volatility, inflammability, levity, and a peculiar odor called ethe- 
real, are the distinctive features of the ethers. 

The sulphuric or vitriolic ether, being the most in use, claims 
attention first. It can be made by heating in a glass retort 
equal quantities of sulphuric acid and alcohol, gradually mixed. 
The vapors which pass over are carefully collected in a vessel 
kept constantly cold by means of ice. The product has the 
strong smell of sulphuric ether, is colorless, pungent, intoxica- 
ting, very volatile, and combustible. The two qualities named 
prompt to caution, in pouring the fluid from one vessel to another 
with a lighted taper near at hand, especially in hot weather. 
The vapor is readily kindled, and the contents of the vessel may 
be in a blaze instantly. If a carboy happen to meet with an 
accident so as to be fractured, and the ether thus escape in form 
of vapor, the whole atmosphere will be impregnated, so that the 
incautious taking of a lighted candle into the place will set the 
vapor on fire. I knew a gentleman, afterward a professor in Ten- 
nessee, who was severely burnt by an accident of this sort, the 
scars being indelibly fixed on his face. 

It should be recollected by all dispensers of ether that when 
added to water, if it be a very concentrated article, the ether 
will float on the surface, and therefore the vial should be well 
shaken. We do not often get an ether quite so strong, however, 
for it is generally over-diluted with alcohol. When needed in a 
chemically pure state, it should be tested for sulphuric acid, a 
portion of which is often present. The solution of hydrochlorate 
of barytes added to a little of the ether will give a copious, in- 
soluble, white precipitate of sulphate of barytes. 

The action of ether on the surface of the body is often an im- 
portant practical auxiliary, and it varies with the manner of use. 
Thus, if it be poured on a spot and be allowed to evaporate : a 
marked feeling of cold will ensue ; and in this way severe head- 
ache has sometimes been treated successfully. On the same 
principle it has been employed to reduce hernia — the cold and 
consequent contraction of the parts favoring the result. Burns 
and scalds have been well managed in the same way. 

But if a compress be soaked in ether and bound to a part with 



USES OF SULPHURIC ETHER. 447 

a well-applied bandage so as to prevent evaporation, in place of 
a feeling of cold there will soon be greatly augmented heat. In 
this way sulphuric ether proves a rubefacient, and even a vesicant. 

Exhibited internally, sulphuric ether has been regarded a 
good diffusible stimulant, and the dose for this end must be fre- 
quently repeated. From fifteen to thirty drops may be given to 
an adult on sugar or in water every fifteen or twenty minutes. 
Brande records the fact that a teaspoonful at one dose, given a 
little while before an expected chill, has prevented it by the sud- 
den and severe shock inflicted. Something like temporary suffo- 
cation is induced in this way. Dr. Challeton affirms that he has 
been in the habit of curing ague and fever by this practice, and 
has succeeded also by giving the ether in smaller doses, at inter- 
vals of four hours, on the well day. (See American Medical Jour- 
nal, Oct. 1847.) The practice, however, is more ancient than 
either of the gentlemen whose authority has been given. This 
is evident from a statement made by Mr. Davidson, a London 
apothecary, in vol. v. of Medical Facts, an old and almost obso- 
lete journal.* He relates several cases of tertian and quartan 
ague cured by swallowing a drachm of sulphuric ether just be- 
fore the expected cold fit. He regarded it as always successful 
and safe when there existed no organic obstruction. He men- 
tions a case of epilepsy cured in the same way. In very delicate 
females, and in persons predisposed to apoplexy, I should con- 
sider the practice unsafe. 

Teaspoonful doses of sulphuric ether have been administered 
in fits of hysteria and epilepsy, and although the desired effects 
appeared to follow, the practice must be regarded as hazardous. 
The mere antispasmodic use is a different thing, and may be re- 
sorted to with safety in very many cases in doses varying from 
twenty to sixty drops given on sugar. Fits of colic dependent 
on flatulence are often soon relieved in this way. Sometimes we 
combine it with the fetid tincture and spirits of camphor advan- 
tageously. The employment of sulphuric ether for the relief of 
pertussis and asthma was based on its antispasmodic action, and 
I have no doubt that twenty-drop doses of the latter and five- 
drop doses of the former may often be salutary. (See Wood's 
Addenda to Medico- Chirurgieal Review, July, 1847.) Aware 
that doses of ethers, as usually exhibited, were much reduced by 
evaporation before being swallowed, recourse has been had to 
the exhibition of the medicine in capsules. M. Clertan has seen 
neuralgia, hemicrania, and gastralgia arrested at once by two or 
three of these capsules, while common ether draughts and ether 
in syrups have signally failed. 

* Published nearly a century ago. 



448 ETHEREAL INHALATION. 

The capsules can be administered in a dose of certain unifor- 
mity. They are inodorous, and may be kept on hand for an in- 
definite time without deterioration. Besides all this, the ether 
in capsules never irritates the membrane of the mouth or 
pharynx, and hence does not induce coughing. — Braithwaite, p. 
xxvii. p. 320. See article Capsules. 

The inhalation of ether has long been practiced by persons 
laboring under nervous headache, and they have often been sig- 
nally relieved. I have known such persons to put the bottle to 
the nose and snuff up the vapor for the space of five minutes, 
with frequent success. This was probably the earliest and sim- 
plest inhalation of ether with the view of assuaging pain. Dr. 
Pearson, of London, more than a century ago, resorted to inha- 
lation of cicuta and sulphuric ether for the purpose of making 
expectoration free and easy. From twenty to thirty grains of 
powdered cicuta leaves were added to an ounce of sulphuric ether 
and the mixture digested for the space of three days. A pretty 
strong ethereal tincture was thus obtained, one or two teaspoon- 
fuls of which added to a small teacup of warm water, with a 
funnel over it, constituted the inhaling apparatus. From five to 
ten minutes served for the inhalation of enough to develope de- 
cided expectorant qualities. 

A pernicious practice prevailed in the Northern Liberties of 
Philadelphia many years ago, in the inhalation of ethereal gas by 
young lads merely as a matter of sport. Common hog's blad- 
ders were procured and fitted with a kind of mouth-piece of 
ivory, or wood, or tin, as happened. A small quantity of sul- 
phuric ether was placed in the bladder, which was then dipped in 
hot water to convert the ether into gas or vapor. The inhalation 
of this gas acted variously, resembling in some the effects of 
nitrous oxide gas. In others, severe pain in the head and phre- 
nitis followed, and at last one of the boys died of inflammation 
of the brain. The poisonous agency was so obvious as to call 
forth the action of the municipal authorities. A paper on this 
subject was published by Dr. Klingle, since deceased, and refer- 
ence is made to the facts in my Elements of Chemical Philoso- 
phy, published in 1832. An account somewhat similar was pub- 
lished in a medical journal in the West a few years ago. 

The inhalation of ether has come into pretty general use in 
various parts of the world, with the design of annulling con 
sciousness, and so enabling patients to endure painful operations. 
It has also found its way into the practice of midwifery, and has 
some bold and respectable advocates. 

In Banking s Abstract, part vii. page 140, the reader may 
find a case of inversion of the womb that continued for sixteen 
and a half months, refusing to yield to all the usual means of 



ETHEREAL INHALATION. 449 

reduction. It was finally managed by the anaesthetic power of 
sulphuric ether. 

The moral relations of the state of unconsciousness induced by 
ethers are exceedingly important to society. A dentist attempted 
a rape on a girl of sixteen, to whom he gave the ether in order 
to prepare her for the extraction of a tooth without pain. (See 
3Iedical News, Oct. 1847.) And a preacher was deposed in the 
South, a few years since, for attempting to have connection with 
a female by resorting to the same anaesthetic agent. These and 
similar facts may serve to show how deleterious this instrumen- 
tality may prove in the hands of depraved men. 

My own opinion of the principle involved has been set forth 
with sufficient plainness under the article chloroform, to which 
the reader is referred. And yet it is conceded that cases may 
arise in which the inhalation of sulphuric ether and chloroform 
may be proper. Dr. Tusson, a surgeon in the Ottoman army, 
gives his personal experience of the efficacy of ethereal inhala- 
tion in Asiatic cholera. He was attacked in the night, alone, 
and wholly unprovided with medicine, except a bottle of sulphuric 
ether. He applied this to his nose and drew in the vapors as 
fast as he could. His respiration became tranquil, his general 
uneasiness subsided, he fell into a sound sleep which continued 
about six hours, perspired freely, and awoke in comfortable 
circumstances. 

In all diseases likely to have a fatal termination, as tetanus 
and hydrophobia, it is entirely proper to employ ethereal inhala- 
tions, and they have been used with success. 

The pure sulphuric ether of the manufacturers, diluted with 
twice its weight of rectified spirit, constitutes the sulphuric ether 
as commonly employed in practice. The compound spirit of sul- 
phuric ether contains some oil of wine, and is a substitute for 
Hoffman s anodyne. The aromatic spirit of sulphuric ether 
is ether combined with aromatic oils. The absolute sulphuric 
ether can be preserved a great length of time, while the common 
article is liable to decomposition, especially if kept in a careless 
manner. 

Nitric ether is prepared pretty much in the manner as de- 
tailed in respect of sulphuric ether. The chief difference is in 
the acid. Pure nitric ether is rarely employed in practice. The 
article called sweet spirit of nitre, spiritus nitri dulcis, &c, is 
the alcoholic solution of nitric ether ; hence it is sometimes called 
ethereal nitrous spirit, spirit of nitrous ether. The diluted as 
well as the concentrated article has a peculiarly grateful odor, 
a pungent yet rather sweetish taste. The sweet spirit of nitre 
mixes well with water, and is readily decomposed if badly kept. 



450 SWEET SPIRIT OF NITRE — CHLORIC ETHER. 

Its freshness and goodness, it is said, may be shown by the ad- 
dition of tincture of guaiacum, which gives a deep-blue color, 
which is supposed to result from a small portion of free nitric 
acid. 

There is a good deal of diversity in the profession touching 
the medicinal power of sweet spirits of nitre. Some physicians 
hold it to be indispensible, while others never employ it. My 
own opinion is somewhere between these extremes. Alone it is 
not often useful, while blended with other articles it is occasion- 
ally valuable. I think it increases the diaphoretic action of 
spiritus mindereri, and may be added with advantage. Added 
to antimonial wine it is sometimes well suited to the diseases of 
children, and the effect is diaphoretic and diuretic. Five drops 
of the latter and ten of the former may be given to a child a 
year old, and repeated every hour or two. The effects are in- 
creased by the exhibition of warm diluent drinks. 

The late Dr. Eberle administered the spiritus nitri dulcis as a 
direct sedative in fevers, in tablespoonful doses. But I feel 
assured that the primary action is stimulant, and consequently 
the final action, if sedative, must be in the nature of an indirect 
sedative. 

In purchasing this article physicians should prefer the highest 
priced quality. It is really the cheapest, and can be preserved 
for the longest time. 

Acetic ether, made by the distillation of acetic acid and alco- 
hol, is not much employed, It has had some repute in the treat- 
ment of gout and rheumatism, externally applied. Dr. Sedillot 
prescribed a half-ounce to be rubbed into the affected parts, and 
to be repeated every two hours. He regards it as a sedative and 
anodyne. 

Chloric ether has been noticed briefly in the article chloroform. 
It is made by the distillation of a mixture of chloride of lime 
and alcohol, as is stated under the article chloroform. It is a 
very grateful stimulant and antispasmodic. 

Dr. Black (see London Medical Gazette, 1833) has found it to 
afford prompt relief in spasmodic asthma in drachm doses. He 
speaks of its pleasant qualities in very decided terms, and thinks 
it a valuable medicine. 

A reporter, in the Association Medical Journal for Sept. 8, 
1854, (Geo. B. Mead, Esq.) deals in large figures to prove the 
efficacy of chloric ether in the treatment of intractable diarrhoea, 
such as he saw in the epidemic form in Bradford, Yorkshire, in 
1846, '47, and '48. He says he has used the remedy in fifteen 
hundred, and, not improbably, in three thousand cases, with- 
out one failure ; well, that is success, certainly, and perhaps 



USES OF BONESET. 451 

there is no mistake- Time, the potent revelator, will show how 
the matter stands. The prescription is, 

]£. — Etheris chlorici, £ij ; 

*Speciei pro. conf. arom. gss ; 
Misturse cretse compos, ^vi. 
TT|. — Fiat mistura. One-fourth of this to be taken at once, by an adult, and 
the same quantity repeated every half hour, or at longer intervals, according to 
the violence of the seizure. Sometimes an opiate was added, but this was rarely 
needful. 

The effects were marvellous. The spasms and pains were 
abated as if by a charm, the diarrhoea ceased, extremities re- 
gained a natural temperature, pulse rose, and the whole aspect 
was decidedly changed for the better. 

Ethiops Mineral. (See Hydrargyrum.) 

Eupatorium Pekfoliatum. Thoroughwort. Boneset. — This 
is an indigenous vegetable found in almost every part of the 
country, sometimes along small streams and in meadows. The 
whole plant is medicinal, and is so well known to the common 
people as well as to physicians that a description is not needful. 
The leaves and flowers are generally preferred. When chewed 
they impart a bitter taste with a peculiar flavor, destitute of as- 
astringency or acrimony. All the valuable properties of the plant 
are taken up by water, and hence the cold infusion and decoction 
are employed. The powder and cold infusion as well as the ex- 
tract possesses useful tonic properties, improving digestion and 
invigorating the whole system. 

The warm infusion or decoction is emetic, sudorific, cathartic, 
and diuretic. The extract is readily prepared by making an 
intensely strong decoction and slowly evaporating the filtered 
liquor. The infusion or decoction may be made just as strong as 
practicable, and needs no detail. 

It is proper to say that for many years the common people 
have been in the habit of curing ague and fever with the boneset 
alone, and I know physicians in the West who resort to it for 
this end. They administer a strong infusion or decoction as hot 
as it can be swallowed comfortably, for the purpose of vomiting 
freely. This is accompanied with copious sweating, and the 
bowels are also evacuated. During the intermission, the cold 
infusion, or cold decoction, or the extract, is given freely, to 
operate as a tonic and antiper iodic. From two to five grains 
of the extract may be taken every hour. Many practitioners 
esteem the boneset in all these relations as fully equal to Peru- 
vian bark. 

* Some readers will be puzzled to understand this part of the formula. It 
refers to the powder used in making the aromatic confection, the composition of 
which is cinnamon, cardamom seeds, and ginger, in fine powder, each ^ij, to be 
intimately mixed. 



452 USE OF EXPECTORANTS. 

Dr. Peebles, of Petersburg, Virginia, reports very favorably 
of boneset in the treatment of epidemic influenza. (See Ameri- 
can Journal of Medical Sciences, April, 1844.) Here it acts 
chiefly in virtue of its emetic and sudorific properties. 

In persons of feeble constitutions, who cannot bear tartar 
emetic, the warm infusion of boneset will be found a very safe 
and efficient emetic, not being followed by the prostration and 
loss of tone consequent on antimonials. 

Exercise. — This is a very valuable therapeutic agent, calling 
for sound judgment in order to salutary administration. We re- 
gret that it is not in our power to enter into its relation to con- 
valescence, especially as we would like to do so, did our limits 
permit. We can only say that it calls for the wisest principles 
of practical medicine to make it safe and valuable. 

Expectorants. — This term is derived from two words import- 
ing from, or out of the breast. It has reference to the various 
applications for promoting expectoration and relieving the chest 
from the difficulties attendant on that process, and is applied to 
all agencies, of whatever kind, that cause the evacuation of mu- 
cus from the secreting surface of the respiratory tubes and cavi- 
ties. They aid in the natural process of expectoration, and rouse 
it when dormant. They may be regarded as uncertain agents, 
because the glandular structure concerned is less prone to be ex- 
cited by medicines whose province is elimination than those 
glands whose special office is to eliminate. Happily they are of 
very various power, and hence if one fails to accomplish the de- 
sideratum others can safely come in as adjuncts or substitutes. 
This book furnishes a large variety. 

The articles and means to promote expectoration are often ad- 
ministered most empirically. One man uses them because they 
have been employed by others, and that is the best reason he can 
give. Ask him how a medicine taken into the stomach can prove 
expectorant, and he is dumb or will give you a stupid explana- 
tion. He has never troubled himself about the matter, and cares 
not a whit how you explain it. Tell him that you employ the 
lancet as an expectorant, or the sulphate of quinine, or a decoc- 
tion of bark, for the same end, and you excite his wonder, for 
that is all new to him. The lancet and tonics as expectorants ? 
Nonsense ! he exclaims ; the idea is preposterous. 

Let me say to all such unthinking practitioners that no remedy 
operates so promptly and effectively as an expectorant as does 
the detraction of blood when well-timed. We see it often in in- 
flammatory affections of the chest, and others might see it too if 
they did not attach such vast importance to some trifling medi- 
cine exhibited at the same time. The strictured state of the 
thoracic organs is relieved by bleeding very speedily ; the parts 



EXTRACTION OF TEETH. 453 

i 

are relaxed, spasms yields, and the sputa will find vent with little 
difficulty. It is on the same principle that minute doses of tartar 
emetic accomplish the same end. 

But, says one, how can the decoction of bark or any tonic do 
that which you say can be effected so readily by the lancet ? We 
reply that these remedies are adapted to opposite conditions of 
the system, and their right use calls for judgment rather than for 
memory. A debilitated condition may be as real a cause of diffi- 
cult expectoration as may a state of stricture or spasm ; and we 
find it to be so in old persons especially. A few doses of the 
bark decoction or some other kindred medicine will often invigor- 
ate so promptly as to be followed by all the tokens of good that 
the most noted expectorant ever produced. 

It is quite obvious from these views that a reflecting and really 
practical man may very much enlarge the number of therapeutic 
resources not merely in respect of expectorants, but of all other 
means ; and hence the value of a sound discriminating philoso- 
phy, that surveys the actual system in its entire extent unfettered 
by the stereotyped fantasies of the schools. The man who does 
his own thinking rather than allow anybody and everybody else 
to think for him is the man to make the wisest adaptations for 
the cure of disease. 

Making all due allowance for the operation of certain means 
by sympathetic agency, we feel confident that the expectorant 
action of most remedies depends on their power to reduce or 
elevate the general vigor — in other words, that they are depend- 
ent, directly or indirectly, on their potency as stimulants or 
sedatives. We perceive this manifestly in reference to the 
lancet and tartar emetic, and have no doubt that less potent 
means operate pretty much on the same general principles. 
The counter-irritant action of a blister on the chest, although 
explained by its counter-irritation merely when it proves expec- 
torant, does really deplete from the organs implicated; and this 
is most obvious when we keep up a discharge from the irritated 
surface for several days, to make the result more certain. 

Extraction of Teeth. — I notice this here because of its 
importance to health. Sound teeth have been extracted with 
decided and permanent relief of chronic and distressing affec- 
tions. I knew a lady who suffered severely for a long time with 
facial neuralgia that resisted all kinds of treatment. She had 
not a decayed tooth, but felt confident that the removal of three 
or four sound ones, in close proximity to the part affected, would 
give relief. She resided in the country, and applied to her phy- 
sician to extract the teeth, a service which he was unwilling to 
perform, as the teeth were perfect. Discovering her determina- 
tion to accomplish the object at all risks, he was at length in- 



454 EXTRACTS. 

duced to comply with her wishes. The teeth were removed and 
the neuralgia ceased, nor has it ever returned. 

Decayed teeth are frequently very prejudicial to health, and 
should be removed in all cases of chronic disease affecting the 
nervous system. I have known epilepsy to be permanently cured 
by the extraction of all the decayed teeth of the individual. A 
case of catalepsy that fell under my notice some years ago, and 
which had resisted all ordinary means, yielded to this device. 
I have known very troublesome neuralgia of the face and neck 
to disappear under the same treatment. It merits the serious 
attention of all practitioners. 

The London Lancet for February 14 and March 21, 1857, 
contains two valuable articles on the effects induced by carious 
teeth. Supposed cancers of the cheek, fistulous sores of the face 
about the lower jaw, malignant-looking tumors on the tongue, 
sores in the throat, purulent discharges from the nostrils, and 
other unpleasant consequences are detailed in numerous cases 
presented in the. articles. We refer the reader to Braithwaite s 
Retrospect, part xxxv. pp. 97-98, for a fuller account. 

Extracts. — These are often useful preparations, containing 
in a small bulk a large amount of medicinal power. Con- 
centrated decoctions of vegetable substances, by slow evapora- 
tion, furnish the most of our extracts. These are sometimes 
injured and even ruined by the application of too intense heat, 
in consequence of which the vegetable is decomposed and ren- 
dered worthless. This may account, in part, for the very large 
doses of extracts reported as having been administered almost 
without effect of any kind. A good extract should possess, in 
some degree, the odor of the vegetable from which it is made, 
and be wholly free of a burnt or empyreumatic smell. 

We may prepare all the extracts either with water or alcohol. 
The principal difference is in the greater liability of the one 
than the other to spoil. The antiseptic quality of alcohol secures 
an extract for an almost indefinite period, while the watery pre- 
paration will soon spoil, unless kept in a very cold place. There 
are also some ingredients of vegetable matter that require 
alcohol for solution, and these cannot, of course, be taken up by 
water. Of the vegetable matters, easily procured every year, 
very efficient extracts can be made simply by forming a very 
strong decoction with water and evaporating to a due consist- 
ence. Hemlock, stramonium, and some other narcotics, can be 
thus made into extracts of a very good quality, and may be kept 
with due care until the next season, when a fresh supply can be 
procured. 

Farina Triticea. Wheat Flour. — We introduce this article 
here chiefly to notice its excellence as a remedy for burns and 



WHEAT FLOUR. 455 

scalds. In the year 1832 a paper was read before the Ohio 
Medical Lyceum, in Cincinnati, by Dr. Jno, Thomas, of England, 
setting forth the manner in which he had treated burns and 
scalds with the greatest success, viz., by covering the parts com- 
pletely with wheat flour and allowing it to remain until sponta- 
neously separated. The London Lancet contains a paper by 
the same individual, and somewhere near the date named above. 
The plan was reported as attended with the happiest results: 
soothing the burning pain effectually and speedily, promoting, 
at the same time, the salutary healing beneath. 

The New York Medico- Qhirurgical Bulletin for 1831-2, 
copies largely from Dr. Thomas ; and the extracts furnish cases 
in which the flour and Kentish practice were tried simultaneously 
on the same person, an arm being dressed in each way. The 
former was admitted to be by far the better plan of treatment, 
and its action ascribed to its complete exclusion of the atmo- 
spheric air, in agreement with the suggestion of Baron Larrey, 
"that the injured surface should be exposed as little as possible." 

I have been in the habit of naming this practice in my lec- 
tures, and of accounting for its complete success by the perfect 
manner in which it excludes the air from the exquisitely tender 
surface, as the above statement teaches. The January number 
for 1850, of the American Journal of Medical Sciences, has a 
paper furnished by Dr. Reese, of New York, in which the flour 
treatment is very highly praised. As there suggested, the 
numerous steamboat scaldings would probably be more happily 
managed by the flour dressing than in any other way; and the 
article is always at hand.* 

Wheat flour is also a very pleasant application to parts labor- 
ing under erysipelatous inflammation; and it would be much 
more signally efficacious if the surface were perfectly coated 
with the flour. Burning and itching of the skin from any cause 
is speedily relieved by this dressing freely applied. We are 
aware that rye flour and buckwheat flour are employed for the 
same purpose. 

Wheat flour presents also a convenient mode for the exhibition 
of gluten, as an antidote for the poison of corrosive sublimate. 
A small handful stirred into a quart of water will answer for 
this end, and the mixture should be given ad libitum. 

Within a few years a very neat article has been introduced, 
called farina, and sold as a superior kind of diet for the sick. 

* Shortly after this work first appeared, (in the summer of 1850,) Dr. R. took 
exception to my remarks as to the early use of flour in the treatment of burns, 
and claimed to have introduced the practice to the notice of the profession ante- 
rior to the publication of Dr. Thomas. We do not now recollect his precise 
statement, but think it simply right to give credit where credit is due. 



456 FENNEL — IRON. 

It would seem to be a sort of sublimated wheat, abounding in 
nutriment and being quite agreeable. It is prepared like arrow- 
root, for which it is often used as a substitute. 

Fennel. Sweet Fennel. Aneihum Foeniculum. — These well- 
known seeds are decidedly aromatic and warm. They contain a 
great deal of essential oil, and are stomachic and carminative. 
The root is said to be pectoral and diuretic. The oil of fennel- 
seed possesses all the qualities of the seed, and is useful in flatu- 
lent colic in doses of one to five drops on sugar. 

Ferrum. Iron. — The simplest medicine derived from this 
source is the article called limatura ferri, ramenta ferri, or, in 
plain English, iron or steel filings, or dust of iron. The exhibi- 
tion of this agent as a tonic and anthelmintic is universally 
known to the profession. It is probable that, in all cases of its 
tonic action, the filings are first oxidized and then changed 
partly or wholly into a lactate. If the action be anthelmintic 
only, the effect may be, and probably is, dependent on the 
mechanical property of the filings. The dose may vary from 
five grains to half a drachm, and is readily exhibited in syrup. 

Iron reduced to an impalpable gray powder by the action of 
hydrogen gas on the heated oxide, according to the method of 
M. Bouchardat, has been regarded as a better preparation than 
the filings, because more readily changed into the lactate in the 
stomach. The dose is from five to ten grains. (See American 
Journal of Medical Sciences, Jan. 1847.) 

The article called clinkers, a refuse of the smith's forge, and 
probably an impure oxide, has been employed as a tonic. (See 
Braiihwaite s Retrospect, part v.) 

The well-known rust of iron (rubigo ferri) is among our best 
ferruginous medicines. It is called the carbonate, subcarbonate, 
proto-carbonate, precipitated carbonate, sesquioxide, &c. &c. And 
while some physicians make important practical distinctions in 
regard to these names, my own belief, as the result of a good 
deal of observation, is that the same identical article is sold 
under all the titles given, — the real difference depending wholly 
on the purity of the medicine, as secured by frequent washings 
with pure water. It can be made with little difficulty by dis- 
solving one hundred and forty-four grains of crystallized carbon- 
ate of soda in a sufficient quantity of water to take it up. This 
solution is to be poured into a vessel containing one hundred 
and thirty-nine grains of crystallized green sulphate of iron 
dissolved in an ounce of water. The precipitate must be col- 
lected on a filter and repeatedly washed. In the process there 
is mutual decomposition, the resulting compounds being sulphate 
of soda and carbonate of iron. As the collected precipitate 
dries it changes color gradually from a dingy green to a brown, 






TONIC IRON POWDERS. 457 

which is the proper color of the rust of iron. The latter name 
is readily comprehended. Iron exposed to moisture and air 
soon becomes rusty or oxidated, and in this state it absorbs 
carbonic acid from the atmosphere. A carbonate of the protoxide 
of iron is thus spontaneously formed. 

This preparation is justly regarded as one of our best tonics, 
whether given alone in five-grain doses or in the shape of what 
are called the tonic powders, consisting of the rust, some vege- 
table bitter, and aromatic. Thus : — 

R. — Carbonate of iron, 
Powder of Calumbo, 
Powder of ginger, each a drachm. 
Mix well, and divide into twelve powders, one of which to be given three 
times a day in syrup or sweetened water. 

The mistura ferri composita, or compound iron mixture, is 
made on the same principles as the rust of iron, and very closely 
resembles Griffith's tonic mixture. The dose is from one to 
three tablespoonfuls three to five times a day. It is thus pre- 
pared: — 

R. — Gum myrrh, (in powder,) a drachm; 

Carbonate of potash or soda, twenty-six grains ; 
Rose-water, seven and a half ounces; 
Pulv. sulphate of iron, a scruple ; 
Oil of cinnamon, ten drops ; 
White sugar, two drachms. 

Rub all the articles well together, excepting the sulphate of 
iron, and then add that salt, shaking the whole frequently. 
Double decomposition ensues, and carbonate of iron is formed. 
The mixture is clearly an incompatible one, chemically consi- 
dered, and yet it is often a very useful one. 

It must be borne in mind that all the preparations of the 
carbonate of iron sometimes induce cardialgia; this may result 
from too large or too long-continued doses. To prevent or 
modify this result, a few grains of the white oxide of bismuth, 
or the calcined magnesia, will be found to answer very well. 

The carbonate or rust of iron is not soluble in water, while 
the bicarbonate dissolves readily. It is in the latter form that 
the salt exists in chalybeate springs. We can make an excel- 
lent substitute for the water of those springs by dissolving three 
grains of sulphate of iron and sixty-one grains of bicarbonate of 
potash or soda in a quart of cool water, in a close vessel, taking 
care to shake frequently. The bicarbonate is thus formed, and 
held in solution. It is the superabundance of carbonic acid, 
furnished by the bicarbonate of potash, that holds the oxide of 
iron in solution. This is manifest from the action of a spirit- 
lamp heat on the new solution. It drives off the excess of car- 
bonic acid, and the iron is precipitated. 

30 



458 USES OF THE RUST OF IRON. 

Carbonate of iron is liable to accumulate in the rectum and 
other bowels when administered for several weeks and in large 
doses, and some fatal results have followed. The evil can be 
prevented by occasionally exhibiting a cathartic dose sufficient 
to evacuate the canal. (See Medico-Chirurgical Review , vol. 

XXX.) 

Very favorable accounts have been furnished to the profession 
of the use of carbonate of iron in pertussis. In the Dublin 
Journal of Medical Science we find a paper by Dr. Lombard, of 
Geneva, on this subject. He gave to children six years old 
thirty-six grains per day in syrup, and thus reduced the number 
and severity of the paroxysms promptly. In chlorosis, there is 
not a better medicine, if the way be quite clear for the mineral 
tonics. In chorea, I have succeeded admirably with the tonic 
powders before named, the shower-bath, and carriage exercise, 
after a state of debility had been induced by too free use of 
cathartics. Some old cases of tic douloureux have been success- 
fully managed with large doses continued for a long time. 

In all diseases in which the blood is manifestly at fault, the red 
globules and other solid constituents being very deficient, the 
preparations of iron soon evince their tonic and invigorating 
power. The whole appearance of the patient is soon changed 
for the better, simply because the blood is restored to its natural 
condition. The experiments of a distinguished foreigner have 
shown, very conclusively, that the solid ingredients of the blood 
in chlorotic patients were augmented one hundred per cent, by 
the use of iron for the space of two months. The propriety of 
the remedy in such cases is therefore demonstrated. I need 
hardly say, if the preparations of iron can thus enter and 
change the qualities of the blood, that the presence of iron in 
the urine can be made manifest. Hence, after but a few weeks' 
or days' exhibition of chalybeates, the mineral can be detected in 
the urine. 

A syrup of carbonate of iron is held to be a better form of 
administration than any other by some who have tried it and 
prefer the carbonate to other salts of that metal. There are 
syrups vended which may or may not be genuine, and hence the 
need of an acquaintance with the best mode of preparation. 
Take of carbonate of potash, half an ounce ; sulphate of iron, 
three drachms and one scruple ; simple syrup, eighteen ounces ; 
water, ten ounces. Dissolve the sulphate of iron and carb. pot- 
ash each in five ounces of the water, and mix the solutions. Col- 
lect the precipitate on a cloth filter, wash it with pure water, squeeze 
it into a pulp as dry as may be, and then rub it well with the 
syrup. The dose of this syrup is from two drachms to half an 
ounce, and can be taken by many who refuse the naked rust of 



MURIATED TINCTURE OF IRON. 459 

iron, even when put in wine. This formula was given by Dr. 
Richardson in the Association Med. Journal for July, 1854. 

The combination of iron with muriatic acid (hydrochloric) 
furnishes a very good medicine, which is prescribed in the form 
of tincture, called muriated tincture of iron, tinctura ferri mu- 
riati, tinctura ferri sesquichloridi, tinctura ferri chloridi, tinc- 
tura martis in spiritu salis, &c. &c. It is made of the rust of 
iron, a half pound ; hydrochloric acid, a pint ; alcohol, three 
pints. The acid and rust are mixed in a glass vessel and shaken 
frequently during three days. The result is a simple muriate or 
hydrochlorate of iron, to which the spirit is next added. The 
mixture, after having been strained, is bottled for use. The 
tincture, so procured, has a grateful ethereal odor, is of a dark- 
brown color, having a marked chalybeate taste, very astringent, 
and decidedly styptic. 

This tincture has been employed both externally and inter- 
nally. Among the external uses we name the treatment of can- 
crum oris — a disease that is very fatal to young children — by its 
application to the gums and other parts affected. (See Medical 
News, Jan. 1844.) Also, the expedient devised by Professor 
D'Outrepont, of Germany, for the arrest of uterine hemorrhage, 
occurring before and after labor. He employed, not strictly 
speaking, the tincture, but the muriate made before the addition 
of the alcohol. He applied this, diluted with water in a sponge, 
so as to plug the vagina, having previously thrown up a portion 
by injection. (See American Journal of Medical Sciences, Oct. 
1844.) 

The internal uses are valuable also. The adult dose is from 
ten to thirty drops three times a day, in infusion of quassia, or 
tansy tea, or simple water. The late Prof. Physick frequently 
administered it in retention of urine, and with decided and 
prompt relief. In hemorrhage of the passive kind it is among 
our best medicines. Old drunkards are liable to hematemesis, 
which is speedily controlled by fifteen-drop doses given every 
half hour. I have employed it very happily in the management 
of gleets of long standing. The dose to begin with is about ten 
drops, gradually augmented to forty, three times a day. It has 
also been administered with good results in gonorrhoea, when the 
more common treatment had lost its power. It cannot be pro- 
per if there be any symptoms of inflammation. The usual pre- 
scription is thus : — 

R. — Muriated tincture of iron, one drachm; 

Sweet spirits of nitre, seven drachms. 
Mix. 

The dose is from forty to sixty drops in simple water three 
times a day. The tincture has also been employed in discharges 



460 MURIATED TINCTURE OF IRON. 

of blood from the urethra, in leucorrhoea, fee. &c. (See London 
Lancet, Dec. 1840.) The same journal for October has three 
cases of diabetes mellitus cured by the tincture. The prescrip- 
tion was as follows : — 

R. — Muriated tincture of iron, two drachms ; 

Laudanum, a drachm and a half; 

Sulphate of quinine, eight grains ; 

Water, six ounces. 
Mix. 

The dose was an ounce three times a day. Animal diet was 
strictly enjoined at the same time. 

The muriated tincture has been employed by Mr. Bell, of 
Edinburgh, for more than a quarter of a century, with almost 
uniform success, as a remedy for erysipelas. It prevents suppu- 
ration entirely, and leaves the patient in a more robust state of 
health than he enjoyed before. 

The bowels having been duly evacuated, fifteen drops of the 
tincture are given in water every two hours, till the disease sub- 
sides. If the attack be more severe, twenty-five drops may be 
given every two hours night and day, however high the delirium. 
The only local application employed was hair-powder and cotton 
wadding. The bowels must be kept free all the while. Persons 
from sixteen to seventy-three years of age have been thus treated, 
with success. The diet should be generous. 

Dr. Balfour has given a good account of a similar practice in 
the Monthly Journal of Medical Science for May, 1853. 

The following preparation had admirable success in arresting 
incontinence of urine in an old man. The difficulty appeared 
to depend on weakness of the bladder, merely a want of tonic 
contractility of the muscular fibres. 

R. — Tinct. ferri. sequihydrochlor. ^ij ; 
Bals. copaib. gi; 
Strychnise, gr. i ; 
Infus. quass. ^xij. 
1^. fiat mist. Dose, an ounce three times a day. 

The man was relieved by two doses only, having had no diffi- 
culty afterward. (See Association Medical Journal, Nov. 10, 
1854.) 

The poisonous action of the tincture merits a few remarks. 
Dr. Combes, of Leith, in England, gives a case in the London 
Lancet, vol. xxxi., of a gardener who swallowed an ounce and a 
half in mistake for whisky or rum. Violent pains of the throat 
and stomach ensued, with nausea and efforts to vomit. The skin 
became cold, the pulse scarcely perceptible. In a little while an 
inky fluid was thrown up and bloody stools discharged. He ap- 
peared to recover under the use of mucilaginous drinks and 



SULPHATE OF IRON. 461 

emollient clysters. In about two weeks afterward he was found 
to be very much emaciated, laboring under severe gastric dis- 
tress, thirsty, and costive. In five days more he was dead. The 
post-mortem examination revealed extensive inflammation of the 
stomach, and a cicatrized patch three inches in length. 

In the London Lancet for Dec. 1843, is the case of a young 
female who took an ounce in four doses, in the same day, to in- 
duce abortion. She was saved by the use of mild cathartics and 
diluent drinks. 

The sulphate of iron is a good medicine. It is tonic, astrin- 
gent, slightly escharotic, and by some regarded as an emmena- 
gogue. It has been known under the various names of green 
vitriol, green copperas, vitriolated iron, sal martis, proto-sul- 
phate of iron, and sulphate of the protoxide of iron. It is pre- 
pared largely for commercial purposes, from iron pyrites or the 
native sulphuret, by exposure to air, moisture, and heat. The 
sulphur of the pyrites is changed to sulphuric acid, the iron is 
oxydized also, and the acid and oxide join to form the salt. The 
impure product is dissolved in pure water, evaporated, and 
crystallized, to get an article of comparative purity. 

The ordinary adult tonic dose is from a half-grain to two 
grains twice or thrice a day, in pill form or otherwise. In cases 
of debility of the alimentary canal attended with occasional 
spasmodic pains and some looseness, I have found no medicine 
preferable to the sulphate. The form of disease named occurs 
not unfrequently in females tolerably advanced in life, although 
it may and does appear in the other sex. The prescription most 
successful is as follows : — 

R. — Sulphate of morphia, three grains; 
Sulphate of iron, twelve grains ; 
Extract of gentian, enough to make twenty-four pills. 

The dose is a pill twice a day, which will generally suffice. 
The symptoms subside in the course of three or four days, or a 
week, if the patient be careful to avoid all exciting causes of 
bowel affection. 

Sometimes the daily use of the sulphate for several days will 
occasion pain in the head if the bowels be not kept in a soluble 
state. The medicine should be discontinued for twenty-four or 
thirty-six hours, and a mild laxative or enema administered. 
The tonic and astringent power of the sulphate is also evinced in 
its tendency to arrest excessive perspiration. For this end two 
or three grains may be taken at bedtime. (See American Jour- 
nal of Medical Sciences, October, 1846.) 

The iron pills of Blaud, so popular in the management of 
chlorosis, were based on the sulphate of iron. To make them, 



462 IRON PILLS. 

equal parts of this salt and the subcarbonate of potash are to be 
well mixed, each having been previously reduced to a fine pow- 
der by itself. The mixture is then to be beaten with enough 
mucilage of gum Arabic to incorporate the articles thoroughly. 
The whole is to be made into pills of the usual size, and to be 
taken so as to increase the quantity considerably every three 
days. Thus, on the first, second, and third days, two pills are to 
be swallowed morning, mid-day, and evening. On the fourth, 
fifth, and sixth days, four are to be taken morning and evening. 
On the seventh, eighth, and ninth days, six pills morning and 
evening, and so on. From ten to thirty days are reported as the 
range of time necessary for a cure. (See Medico- Chirurgical 
Review, April, 1846.) 

It may be proper to say just here that pills of the sulphate of 
iron can be made with much less trouble with the addition of a 
soft bitter extract than in any other way. The pills thus made 
retain their form under all states of weather. 

A watery solution of the sulphate of iron is a good lotion for 
old ulcers, and the strength can easily be suited to individual 
cases. From a drachm to a pint of water will sometimes answer 
very well, but a half-ounce of the salt may be necessary. Velpeau 
praises a solution of an ounce to a pint of water as a wash for 
erysipelatous inflammation. From five to ten grains dissolved 
in six ounces of rose-water will give a good collyrium, and is 
especially suited to subacute ophthalmia. 

Injections of sulphate of iron, a grain to the ounce, employed 
daily for a few weeks, will, it is asserted by Mr. Vincent, almost 
invariably cure prolapsus ani, and render an operation unneces- 
sary. The same injection is also employed to complete the cure 
of internal piles, after having excised them with the knife. (See 
Braithwaite, part xix.) 

An article called by the manufacturer the bisulphate of iron 
was highly extolled some years ago as an emmenagogue. It was 
made by adding rather more sulphate of iron to water than it 
could dissolve. A small quantity of sulphuric acid (a drachm 
to six ounces) was added, and ebullition effected in a clean 
Florence flask by the help of a spirit-lamp. The whole of the 
precipitated salt is quickly taken up, and a transparent solution 
is obtained. The dose is from fifteen to forty drops three times 
a day. It is an excellent tonic, and suited to cases attended 
with great debility. 

Phosphate of iron has been much praised by Carmichael and 
others. There are two varieties of the phosphate, the yellow 
and the blue ; the latter is the agent employed in practice. It 
can be made by mixing equal parts of saturated solutions of 
phosphate of soda and sulphate of iron. Double decomposition 



TARTRATE AND PRUSSIATE OF IRON. 463 

ensues, and the blue phosphate is thrown down, which, after 
washing and drying on a filter, is to be kept in well-stopped 
glass bottles. It is nearly tasteless, and almost insoluble in 
water. The ordinary adult dose is five grains three times a day, 
in syrup. Those who have advocated it the most strenuously 
have done so on the ground of its ready assimilation with the 
animal economy, because its acid is an animal acid. It has 
been employed chiefly in amenorrhoea attended with great debility. 

The tartrate of potash and iron has been a good deal em- 
ployed as an infantile tonic, because of its tastelessness. It is 
sometimes called tartrate of iron, but incorrectly. It is a triple 
salt, or a salt composed of an acid and two bases, not unlike 
Rochelle salt. It can be made by incorporating two parts of 
cremor tartar with one part of iron filings, and exposing the mix- 
ture to the air some fifteen or twenty days, moistening frequently 
with a little water. The iron filings are oxidated, and the oxide 
combines with the excess of tartaric acid in the cremor tartar, 
(or bitartrate of potash,) and hence the resulting compound of 
tartrate of potash and iron. It is of a brownish-green color, 
without smell, and having a very faint styptic taste. It attracts 
some moisture, yet enough to deliquesce, is very soluble in water, 
and the solution can be kept unchanged a long while. One part 
added to seven of pure water makes a proper solution for use. 
The dose is a teaspoonful three times a day for a child from two 
to five years old, and it may be gradually augmented to a half- 
wineglassful. It is a very good tonic. 

The articles called the ammoniated tartrate of iron and the wine 
of iron are of too little value to justify their introduction here.* 

The prussiate of iron has enjoyed a good share of professional 
confidence. It is the well-known Prussian blue, and technically 
the ferrocyanate of the peroxide of iron. In large manufactories 
the prussiate of potash is produced by heating in an iron pot a 
mixture of dried blood, skin, horn, bone, animal offals of every 
kind, with potash. The pot, being closely covered, is exposed to 
a furnace heat so as to effect something like calcination. A 
pasty mass is thus obtained, which is impure prussiate of potash. 
On adding this to a concentrated solution of sulphate of iron a 
deep-blue is instantly struck, Prussian blue being the result. 
Evaporation drives off the water, and the blue compound is thus 
obtained. 

This preparation was formerly exhibited in the treatment of 
inter mittents, having been highly extolled by Dr. Zollickoffer, of 
Maryland, who labored to bring it into general use. The adult 

* A very good substitute for wine of iron is made by adding ten to twenty 
grains of rust of iron to a tablespoonful of wine, and that may be repeated 
thrice in twenty-four hours. 



464 CITRATE OF IRON. 

dose was from five to fifteen grains, repeated several times a day. 
It was held to be a tonic and antiperiodic. The late Professor 
Eberle regarded it with favor as a remedy for chronic hysteria 
attended with general relaxation and weakness. In chronic 
menorrhagia, so troublesome just at the time when the menses 
are about to cease and the system is greatly enfeebled, Dr. E. 
held the prussiate to be an excellent medicine. In these cases 
he prescribed two grains, with half a grain of aloes, three times a 
day. He employed the prussiate also in chronic uterine hemor- 
rhage, with intense nervous debility, in ten-grain doses, gradually 
increased for the space of eight or ten days. 

A writer in the Journal de Medicine et de Ohirurgie Pra- 
tiques speaks in very high terms of the use of prussiate of iron 
in chorea and epilepsy. Several cases are detailed in which the 
curative result was gained in from four to eight days. The fol- 
lowing is the formula : — 

Take of Prussiate of iron, fifteen grains ; 

Extract of valerian, forty-five grains. 
Mix, and divide into twenty-four pills. 

One pill to be taken three times a day at six hours' interval, 
and each pill to be followed by a wineglassful of infusion of vale- 
rian. (See London Lancet, June, 1850.) 

Citrate of iron was introduced to the notice of the profession 
by Dr. Ritchie, of Germany, who regarded it as a very superior 
tonic. It can be made by mixing equal parts of iron filings and 
citric acid, having first dissolved the acid in a little water. The 
whole should be frequently stirred and exposed to the sun, to 
allow the complete oxidation of the iron. The oxide thus pro- 
duced joins the citric acid, and citrate of iron is formed. The 
adult dose is from five to fifteen grains. A compound very simi- 
lar has been made by exposing iron filings and lemon or orange 
juice in a similar manner. 

The citrated aromatic wine of iron, called also tinctura ferri 
aurantiacea, and the vinous solution of the per and proto-citrate 
of iron, has been long a favorite with the German practitioners, 
and is probably a good article. It has a grateful odor and taste, 
is aromatic and carminative as well as tonic. It is made thus : — 
Take four ounces of the purest iron filings or fine iron wire and 
beat with them, in a stone mortar, four Seville oranges free of 
the seeds. Place the whole in a wide-mouthed vessel and allow 
the mixture to stand for three or four days. Then add ten 
ounces of Madeira wine and two ounces of spirit of orange peel. 
Digest for two weeks and then filter. A dark-colored aromatic 
liquor is the product, being highly chalybeate and quite agreeable 
to the taste and stomach. The dose is two teaspoonfuls with 



PERSESQUINITRATE OF IRON. 465 

one of syrup of lemon, for an adult. It was employed chiefly in 
passive or atonic uterine hemorrhage, in chlorosis with great 
debility, &c. &c. (See American Journal of Medical Sciences, 
Oct. 1844.) 

A very pleasant chalybeate draught suited to cases of debility 
can be made as follows : — Take six hundred and twenty-five 
scruples of water, (twenty-six ounces,) one scruple of dry citrate 
of iron, four scruples of citric acid, five scruples of bicarbonate 
of soda ; add the citrate of iron and citric acid to the water to 
make a solution, then the bicarbonate of soda. Instantly cork 
the vessel tight and secure the cork carefully. All the carbonic 
acid gas extricated by decomposition is thus retained in the mix- 
ture, which is a highly agreeable and efficient tonic, especially 
suited to passive uterine hemorrhage and feeble chlorotics. (See 
American Journal of Medical Sciences, 1843.) The dose is a 
wineglass half-full three times a day, and it should be swallowed 
quickly or the carbonic acid gas will be lost. To those who de- 
sire a pleasant chalybeate tonic either of the two preparations 
last named will be very acceptable. 

M. Duchesne Dupare has given an article in the Grazette des 
Udpitaux, (an abridgment of which may be seen in part xxx. 
Braithwaite, page 175,) to show the good effects of arseniate of 
iron in hepatic and squamous diseases of the skin. He says it 
never induces the unpleasant results which frequently follow the 
ordinary arsenical medicines. It is given in doses of one-twenty- 
fifth, one-tenth, or even one-fifth of a grain at first, gradually 
augmented, suited to the age, peculiarities, &c. of the patient. 
In many cases adults were treated with one-fifth of a grain doses, 
continued for weeks thrice a day, and with success. The length 
of time needful for recovery is of course variable, as under any 
other treatment. 

Persesquinitrate of Iron. — This has been much praised by 
Dr. Christison as a remedy for diarrhoea after every trace of 
inflammatory action has subsided. Professor Graves extols it 
very highly for the same purpose. (See Graves's Clinical Lec- 
tures, p. 128.) 

It is sometimes called the solution of nitrate of iron, and can 
be made by adding very small bits of iron wire, weighing an 
ounce and a half, to three ounces of nitric acid, twenty-seven 
ounces of water, and one ounce of hydrochloric acid. The iron 
placed in an earthen vessel is to be first acted on by the nitric 
acid mixed with fifteen ounces of the water. A pretty smart 
action ensues, and persesquinitrate is formed. The liquor is to 
be decanted, strained, and filtered. Then add the hydrochloric 
acid and the rest of the water. The whole process occupies 
about two hours, and when completed a dark-red liquid is ob- 



466 IODIDE OF IRON. 

tained, which in certain exposures seems to be nearly black. 
The solution fades very much unless excluded from the light. It 
is very astringent, though void of causticity. It resembles the 
muriated tincture in point of therapeutic qualities, but it has a 
peculiar tendency to lessen the irritability of mucous membranes. 
The dose is from ten to thirty drops, gradually increased. A 
very good paper on the medicinal virtues of this medicine may 
be seen in the American Journal of Medical Sciences, vol. xxiv. 
Dr. Adams, of Michigan, gave it to a child six months old, labor- 
ing under diarrhoea. Two drops three times a day, continued 
for ten days, worked a most salutary change. The same physi- 
cian has employed it also in the diarrhoea of adults, and thinks 
it eminently suited to the chronic form of that disease. It has 
been administered also in leucorrhoea and Menorrhagia with 
marked benefit, and has been found a useful application to the 
small ulcers that invade the mucous lining of the mouth, both of 
children and adults. Here it acts by virtue of its astringency 
mainly. 

Dr. Reynolds, of Hertford, declares that he has succeeded in 
controlling the diarrhoea and other symptoms of Asiatic cholera 
by a few doses of the persesquinitrate of iron. His testimony 
is confirmed by other practitioners. Sometimes the muriated 
tincture was employed, but it did not answer as well as the other 
preparation named. (See Braithwaite, part xx. p. 345.) 

Iodide of Iron. Ioduret. — Several publications have been 
made touching this compound of iron and iodine, the best of 
which is the memoir of Dr. Thompson. One part of soft iron 
wire, or best iron filings, and three parts of iodine are to be well 
rubbed in a porcelain or wedgewood mortar, adding a little water 
at a time until fifteen parts are added. The mixture is then 
put into a Florence flask, adding a little more iron and some dis- 
tilled water. Boil with a spirit-lamp till the solution acquires a 
pale-green color ; filter and evaporate gradually in a clean flask. 
To get the dry iodide out of the flask, the latter must be broken; 
and as the medicine is quite deliquescent, it must be kept in a 
close glass bottle. When well prepared, it is of an iron-gray 
color, quite brittle, breaking with a foliated fracture, and having 
somewhat the appearance of metallic antimony. When quite dry, 
it is inodorous, has a styptic taste, but without acrimony. When 
this preparation deliquesces, some of its iodine escapes, and it 
is thus injured, more or less. 

In dissolving the iodide of iron for use the solution should be 
boiled with a portion of clean iron wire and then filtered, after 
which it can be kept a good while. The solution is of a pale 
green-yellow color, and contains three grains of iodide in each 
fluidrachm. In order to keep the iodide unchanged, some per- 



USES OF THE IODIDE. 467 

sons add syrup or sugar, which prevents decomposition. The 
addition of a small piece of iron wire is said to answer the same 
end. I think as good a mode of administration as any is to 
add the dose of the solid iodide (from one to three grains) to 
half an ounce or an ounce of the syrup of ginger. There is no 
risk of decomposition then, and the medicine is readily taken. 

Cod-liver oil may be used with advantage as a vehicle for iodide 
of iron in scofulous cases. Two grains of this may be dissolved 
in each ounce of the oil. — Headland's Action of Medicines, 
page 351. 

It should be borne in mind that the watery solution of the 
iodide is decomposed by chlorine, mineral acids, gallic acid, 
tannin, the alkalies, alkaloids, the metallic salts generally, and 
by all astringent vegetable infusions. 

Dr. Thompson was led to place a high value on this medicine, 
partly because of its great solubility, although both of its com- 
ponents are insoluble, or nearly so. In scrofulous affections, 
chlorosis, incipient scirrhus, rickets, amaurosis, bronchocele, 
atonic dyspepsia, and in all conditions of direct debility, Thomp- 
son speaks in high praise of iodine and hydriodate of potash. 
He suggests, as a good form of exhibition, to add two grains of 
the iodide to half an ounce of water, with a drop of oil of cinna- 
mon, for a dose, to be repeated thrice a day. It must be recol- 
lected that in such solutions, unless instantly swallowed, the 
iodide is converted into the hydriodate. 

The advantage of the iodide or the hydriodate is obvious. 
Iodine alone impairs the tone of the stomach; but the iron, 
joined to it, guards against this accident. Hence the appetite 
is improved while the scrofulous diathesis is met. The alimen- 
tary canal is usually stimulated by the medicine, and costiveness 
avoided as well as diarrhoea. The stools are always made nearly 
black, and their fetor is corrected. Sometimes the kidneys are 
excited and the flow of urine is augmented, and, after four or 
five days' administration, the iodine and iron can be detected in 
the urine. 

In addition to the methods pointed out above for the use of 
the iodide it is well to notice the chocolate of the iodide, or hy- 
driodate of iron. Lugol speaks in praise of this compound. 
One hundred and fifteen grains are added to a pint of ordinary 
chocolate, and a half-teacupful may be taken in a day, or even 
a larger quantity. Lozenges have also been prepared, and may 
doubtless suit some persons very well. To make them, 

Take of Iodide of iron, a drachm; 

Powder of saffron, four drachms; 
Sugar in powder, eight ounces. 
Mix, and divide into two hundred and forty lozenges. 



468 LACTATE OF IRON. 

The dose is eight or ten lozenges per day. The New York 
Journal of Medicine and Surgery, Sept. 1846, has a formula 
somewhat different. Thus : — 

Take of the iodide, and of 

Saffron, each, fifteen grains; 

Mucilage of tragacanth, enough to make a mass. 

To be divided into one hundred lozenges, ten of which to be 
taken daily in scrofulous affections, skin diseases, amenorrhoea, 
&c. &c. 

The iodide of iron is also occasionally employed by way of 
injection and lotion. The proportions are about four drachms 
to a pint of water. 

When iodide of iron is taken the iodine passes out in the 
urine, but either none of the iron leaves the system or only the 
merest trace can be detected in the urine. Quevenne found that 
after administering fifteen grains of iodide of iron the iodine 
appeared in the urine in ten or fifteen minutes. In forty-eight 
hours three-fourths had been excreted in this way; but during 
the same period only a trace of iron was discovered in that 
secretion. This, says Dr. Headland, page 168 of his book on 
the Action of Medicines, well illustrates one important difference 
between the catalytic (iodine) and the restorative, (iron.) The 
former must be excreted, the latter may be assimilated. 

Lactate of Iron. — This medicine has acquired great popularity 
in a very brief space of time. With the French it is a great 
favorite, and, I think, deservedly so. It has been preferred 
because of the presence of an animal acid and the consequent 
belief of its more easy assimilation to the animal economy. 
Berzelius has found the lactic acid in muscle, milk, and all the 
secretions. It has been conjectured that the solvent power of 
the gastric juice is due to the fact that it is composed largely of 
lactic acid, and hence the belief that lactate of iron is formed in 
the stomach whenever filings of iron are swallowed. 

Lactic acid is obtained in quantities from whey, and is pro- 
cured from dairies where much cheese is made. With the acid 
so got, iron filings are mixed, adding water in quantity equal to 
the acid. The oxide of iron resulting unites with the acid, and 
hence the lactate, which crystallizes on cooling in the form of 
thin crystalline plates or layers. This salt is not very soluble in 
water, reddens litmus paper, and has a decidedly ferruginous 
taste. If the watery solution be allowed to stand a good while, 
it absorbs oxygen and assumes a yellow color. Bouillaud, 
Rayer, Andral, Fauquier, Gcelis, and others, have employed it 
as a tonic, and esteem it one of the best chalybeate preparations. 
It can be administered in form of pill, lozenge, &c. In chlorosis 
and amenorrhoea it is said to be an admirable medicine. The 



TANNATE OF IRON. 469 

dose is about six grains twice a day. Bouillaud gave twenty 
grains in twenty-four hours. Its effect on the appetite is speedily 
conspicuous. 

Chalybeate bread has been made for the use of chlorotic girls, 
by adding the lactate to dough in the proportion of five grains 
to three and a half pounds of bread. The absence of unpleasant 
taste makes this bread a desirable adjuvant. In the hospitals of 
France it has been used with success, requiring rarely over two 
weeks for complete restoration. (See American Journal of 
Medical Sciences, January, 1842.) 

Tannate of Iron is a medicine of recent introduction into 
Materia Medica. It can be made by the action of pure tannic 
acid on the purest carbonate of iron. Four hundred and forty 
grains of the latter, finely pulverized, must be added gradually 
to a solution of ninety grains of the acid, in a porcelain vessel. 
The mixture must be shaken till effervescence ceases, and then 
exposed to a heat of 212° (boiling) until it acquires the consist- 
ence of soup; after which pour it on evaporating dishes to be 
dried by a temperature not above 98°. The product is tannate 
of iron, of a maroon color, insipid, insoluble, non-cry stalliz able. 
It may be administered in form of syrup or pills. 

A writer in the London Medical Times for Oct. 1848, M. 
Benedetti, commends this medicine very strongly in the treat- 
ment of chlorosis. The time necessary for relief and cure varies 
from twelve to twenty-five days, according to the nature of the 
case. The dose was from five to thirty grains per day. (See 
Ranking' s Abstract, vol. ii. No. 2.) 

One of the results of the use of an iron medicine is the resto- 
ration of deficient coloring matter to the blood. If this fluid be 
analyzed before and after such use, it is found to have under- 
gone a remarkable change, most particularly in the quantity of 
hsematosin which it contains. Dr. Headland relates a case (in 
his book on the Action of Medicines, page 165) in which blood, 
drawn before the use of iron, was found to contain only fifty 
parts of blood corpuscles in one thousand, instead of one hundred 
and twenty, the normal average. The ammoniaco-citrate of iron 
was prescribed in five-grain doses three times a day. After a 
month's use the blood was again analyzed, and the amount of cor- 
puscles was found to have risen to seventy-six parts. At the end 
of another month they reached to upward of one hundred in 
one thousand parts of blood. Meanwhile, the general health 
was much improved. 

Chalybeates have therefore a speedy and obvious effect in 
restoring to the blood this want of haematosin. As the precise 
chemical condition of the iron in haematosin has not been shown, 
so the precise changes which chalybeates undergo before they 



470 FIRING, ITS USES. 

supply the deficit in a fit and proper form are not known. All 
the known soluble compounds of iron, except the ferrocyanide 
and ferridcyanide of potassium, possess this restorative power. 

The following preparations of iron may be administered con- 
veniently in glycerine in the proportions named : five grains of 
iodide of iron to £i of the solvent. The mixture is clear, of a 
beautiful lemon-yellow color, with a highly ferruginous taste. 
The proto-carbonate of iron can be dissolved in glycerine so as 
to be eight times stronger than the compound iron mixture. 
The solution is of a dark leek-green color, and is pleasantly 
ferruginous to the taste. The citrate of ammonia and iron, eight 
grains, will dissolve in one drachm of the solvent. The mixture 
has a dark iodine color, and is slightly ferruginous. The per- 
phosphate of iron, five grains, will dissolve in gL The fluid is 
opake, of a milk-white color, and slightly ferruginous. — Ameri- 
can Druggists' G-azette, July, 1857. 

Firing. — A novel mode of effecting counter-irritation has been 
introduced under the title of firing. The machine for this pur- 
pose is very simple. The whole length is about six inches, one- 
half of which is occupied with the wooden handle, the balance 
consisting of iron. An iron shank is made to terminate in a 
disc or button with a convex surface, the disc being not larger 
than a dime. Sometimes the face of the disc or button is quite 
flat. This is to be held in the flame of a spirit-lamp until the 
finger in contact with the shank feels quite hot. A quarter of 
a minute is sufficient to heat the instrument to this degree, and 
it is then ready for use. The hot disc is just tipped against the 
skin from spot to spot as often as it may be deemed necessary. 
A hundred applications may be made to a limb in a minute. In 
the course of a quarter of an hour, and often in a few minutes, 
the whole skin becomes of a bright red, and the patient feels a 
glow of heat over the part. The iron is never red-hot; indeed, 
it is very little hotter than boiling water, seldom makes an 
eschar, and hardly ever anything like a blister. On the next 
day you may notice some circular red marks, but the cuticle is 
not raised at all; and, if needed, the disc might be reapplied to 
the same spot. 

Dr. Corrigan says he employed it in the case of a medical 
friend, who could not guess what the application was. He knew 
that he felt a smarting sensation suddenly inflicted, but did net 
suspect the source until he saw the instrument. The doctor 
further says, "Some of our resident clinical clerks have pre- 
ferred it in their own cases, when suffering under local rheu- 
matism, to any other kind of counter-irritation, as being the 
least troublesome, the most rapid, the least painful, and most 
effectual." 



POISON OF FISH. 471 

A gentleman, in leaping from a railway carriage, strained the 
muscles of his loins. For two or three days he used liniments 
and a warm bath. He continued to suffer so much that he 
sought other advice. He could not sit down without much in- 
convenience, and to rise from a chair was a labor of torture. 
While conversing with him, and drawing off his attention, Dr. 
Corrigan heated the iron and fired him over the loins. He was 
instantly well. 

The remedy has been used in all varieties of rheumatism and 
in arsenical palsy with most happy results. In addition to the 
paper of Dr. Corrigan, which appeared in the Dublin Hospital 
Gazette, March, 1846, several other papers have found their way 
into the journals fully confirmatory of his statements. We re- 
gard this firing as one of the very best counter-irritants known 
to the profession. For further testimony, see Braithwaite 's Re- 
trospect, part xx. 

Fish. — The dietetic qualities of fish have been variously esti- 
mated, and we do not intend to enter into the subject fully. 
The question came up during the season of Asiatic cholera 
whether fish might be eaten or not, and the profession pretty 
unanimously decided in the negative. In the hot months of 
summer all kinds of fresh fish are notoriously less salubrious 
than in cold weather. The substance of the fish is softer and 
tends more rapidly to putrescence, and hence it is undesirable 
to partake of that kind of diet just then. Moreover, it is well 
known that fish cannot be kept as well in hot weather as in the 
cold months, even though packed in ice ; and it is not improba- 
ble that half-spoiled fish have had this show of preservation just 
to make them more saleable. Much will depend on idiosyncrasy 
as regards the salubrity of fish at any season of the year; and 
not a little on the nature of other articles that may be eaten at 
the same time. Incompatibility may render fish exceedingly 
unwholesome. 

We desire to call attention especially to the well-known fact 
that, from some unknown causes, lobsters, muscles, congers, eels, 
oysters, and various scale and shell-fish, acquire poisonous quali- 
ties. This is particularly the case in the West Indies, but is 
sometimes realized in this country. On this point, Dr. Christi- 
son has well said that, "While it is one of the most singular cir- 
cumstances in the whole range of toxicology, it surpasses all 
others in the obscurity that covers it." He remarks further, 
"That some species of fish, particularly in hot climates, are 
always poisonous ; that some, although generally salubrious and 
nutritive, such as the oyster, and still more the muscle, at times 
acquire properties that render them unfit for eating ; and that 
others, including the various kinds of shell-fish, and even the 



472 FISH POISON. 

richer sorts of vertebrated fishes, are always poisonous to certain 
individuals. Yet, hitherto, chemists and physiologists have in 
vain attempted to discover the cause of their deleterious agency." 

The excellent papers of Christison, Thomas, Ferguson, and 
others, on the poison of certain fishes, relate to tropical climates ; 
but it is notorious that the oyster, lobster, crab, and mackerel 
found in the New York, Philadelphia, and other markets, do 
occasionally induce poisonous results. The muscle eaten by 
some persons always occasions more or less sick stomach, head- 
ache, and cutaneous eruption, in our most northern latitudes. 
And the various kinds of shell-fish never fail to bring on a like 
condition in many individuals, who, of course, are compelled to 
abstain from them. 

In respect of muscles, there is unquestionably not a little due 
to constitutional peculiarity or idiosyncrasy. 

Millingen, in his Curiosities of Medical Literature, says that 
a family in Boulogne was poisoned by muscles, and all the other 
families who ate freely of them escaped unhurt. He speaks, too, 
of an entire family eating crabs without injury, excepting in the 
case of a young girl, who was so severely sickened that she 
quickly died. 

An interesting case of poisoning with muscles is related in the 
London Medical Grazette, vol. xix. page 85. About a dozen were 
eaten by the patient, a female aged thirty-nine, of good general 
health. The family ate of the same meal, without injury. In 
a quarter of an hour she was seized with weariness, gastric pain, 
itching of the skin, swelling of the face and eyelids, cramps in 
the legs, &c. Milk was given freely, and caused a speedy abate- 
ment of all the symptoms, and final recovery. 

The Madras Lterald of Feb. 2 mentions the arrival there of 
the ship Gangas, which had suffered severely from fatal sickness 
on board, arising from a singular circumstance. Shortly after 
leaving Mauritius, the Gangas hove to off a fishing-bank and 
let down the boats to fish. The men were successful, and ate 
plentifully of what they had caught. They were affected in a 
very extraordinary manner, being swollen like porpoises, and in 
the course of a few days fifteen of the men died. 

The Abington (Va.) Statesman of August 3 says, "A few 
days since, two families, residing on the north fork of Holston 
River, in this county, were poisoned by eating an eel caught in 
that stream. They partook of the eel at the usual breakfast 
hour, and in the course of a few hours were assailed with the 
symptoms usually attending the disease called milk-sickness. 
Medical aid was promptly called in, and they are now re- 
covering." 

It was supposed, many years ago, and the conjecture has since 



FISH POISON. 473 

been revived, that the poison of fish was occasioned by copper ; 
but there is not the slightest foundation for this opinion. The 
most accurate and oft-repeated experiments disprove the notion 
entirely. And we are compelled to believe that the evil is 
partly attributable to some peculiar quality of the fish at cer- 
tain times, and partly to the inexplicable idiosyncrasy of indi- 
viduals. 

This view is corroborated by the statement of Dr. Grainger, 
who resided for several years at St. Christopher's Island. He 
says it often happened that fish of the same kind caught at 
one end of the island were among the best and most wholesome 
in the world, while those caught at the other end, at the same 
time, were not only dangerous but often fatal ; and that the same 
species which on one day served for good nourishment proved 
the next day highly deleterious. 

The symptoms commonly following the use of poisonous fish 
are, uneasiness and pain about the stomach, with sickness and 
headache, vertigo, redness and swelling of the face, a species of 
nettle rash over all the body, shortness of breath, sometimes 
cold extremities, delirium, and convulsions. These usually com- 
mence in a couple of hours, and quickly reach their maximum of 
intensity. The duration of the attack, whether fatal or not, is 
very variable, death sometimes occurring in a few hours, and 
sometimes not for three or four days. 

The morbid appearances in the dead body throw little light on 
the subject. A slight inflammation of the stomach and bowels 
is sometimes evident, yet in some cases there is nothing of the 
sort. 

The treatment, in the first instance, consists in means to dis- 
lodge the poison. For this purpose, the stomach-pump, or an 
emetic of sulphate of zinc will be necessary. This may be fol- 
lowed by oleaginous cathartics and clysters. Diluents and 
mucilaginous drinks will also be proper ; and if the gastric irri- 
tation be great after the dislodgment of the poison, anodynes, 
particularly in the endermic way, will be proper. From twenty 
to forty drops of sulphuric ether on a little sugar have also been 
employed with advantage, it is said, to quiet the irritable condi- 
tion of the stomach. The application of rubefacients to the 
epigastrium may also be very serviceable, and in some cases 
leeches will be found necessary. 

It is proper to mention here the very painful affection occa- 
sioned by a wound inflicted by the fins of a fish just after being 
caught. Catfish are most likely to do this mischief. The wound 
is small, but a most distressing, stinging sensation, attended with 
some tumefaction, speedily follows. Young persons of consider- 
able firmness cry out under the pain thus occasioned. A verv 

31 



474 IMPORTANCE OF FLANNEL. 

simple expedient will generally give prompt relief. If an onion 
be cut in half and the clean surface applied to the wound, the 
unpleasant symptoms soon vanish. I have tried this remedy 
frequently, and with uniform success, having learned its value 
from a lady whose family physician I was for several years. It 
is more than probable that liquid ammonia would answer equally 
well with the onion. 

Flannel. — The importance of this as a part of clothing is 
generally conceded. There are some, however, who do not use 
it in their own persons, nor advise it for others. The testimony 
of some of the ablest men in the profession has settled the point 
conclusively as regards all very changeable climates. It is next 
to impossible to guard against all the vicissitudes that occur in 
this country, even in the season of winter, when most care is 
paid to the clothing. Especially is this true of those who have 
all their clays been accustomed to a more genial clime, and who, 
from the necessities of business, are compelled to sojourn in New 
York or Philadelphia through the winter. In vain do they throw 
around them the heavy cloak while the surface of the body is 
unprotected by the non-conducting flannel. I have known per- 
sons who wore flannel next to the skin to be so completely proof 
against chilly sensation in the coldest weather that they were sel- 
dom if ever seen with a great coat or cloak, or anything of the 
kind ; while others, in the same town, wrapped in two or three 
overcoats, were all the while complaining of the cold, and the 
reason was that the latter could not be induced to wear the flan- 
nel shirt. 

There are those who wear flannel advantageously throughout 
the year, selecting, however, the thinnest and oldest garments for 
warm weather. Such persons are guarded against the evils of 
profuse perspiration, which hurt others so seriously who wear 
muslin or linen next to the skin. The latter allows the ready 
and rapid evaporation of the perspirable matter, which the flan- 
nel is calculated to check. The wearers of fine flannel are less 
apt to be chilly after a free perspiration than those who do not 
wear it, and the reason is obvious. 

It has been contended, and perhaps correctly, that in order to 
derive the full benefit from flannel, it ought not to be worn at 
night. The body being sufficiently protected in bed, does not 
require the aid of flannel, and is better without it. In the event 
of perspiration at night, too, the flannel, it is said, is rendered 
less fit for the development of non-conducting power in the day- 
time, when that power is most needed. 

All delicate persons with weak breasts, and who fear pulmo- 
nary attacks, should wear flannel throughout the winter season 
and a considerable portion of the spring. It is desirable to 



GOOSE GRASS — NUT-GALLS. 475 

change the garment once a week, or more frequently if the indi- 
vidual perspire much. 

The application of a soft flannel bandage around the body, 
covering the stomach and bowels completely, was found to be 
salutary during the prevalence of epidemic cholera in this city in 
1849. The bandage should be three or four inches wide and 
three or four yards long, and applied so as to give support to the 
body. Such a contrivance, although simple, has calmed the fears 
of the nervous who confided very much in its efficacy. 

A like bandage has proved useful a thousand times in the 
management of cholera infantum. It not only operated me- 
chanically, but prevented the accidents which follow sudden 
changes of the weather ; and if it should irritate the skin, so 
much the better, as that would tend to attract disease to the sur- 
face. A very silly objection has been raised against this prac- 
tice, viz., that it induces internal congestion, or augments it. 
The very opposite is the true state of the case, as every sensible 
practitioner knows. 

Galium Apaklne. — G-oose Grass or Cleavers. — This is an old 
remedy for dropsies, acting as an aperient and diuretic. It en- 
ters all the books of what is called the botanical practice. 

We have seen several very favorable notices of this article 
within a few years in the foreign journals, and perhaps in some 
of our own. The plant grows abundantly in the United States 
as well as in England, and has long been known to the peasantry 
of the latter as a remedy for certain cutaneous diseases, and 
especially the Lepra vulgaris of the books. Dr. Winn read a 
paper before the Lond. Med. Society not long since, to show its 
application to cases of scrofulous and cancerous diseases. He 
thinks that Dioscorides knew something about its virtues, and 
that the Italians and Germans have long been familiar with it. 
At first Dr. W. employed a decoction of the galium, but after- 
ward procured an inspissated juice from Mr. Hooper, of Pall 
Mall, a teaspoonful of which is equal to a pint of the decoction. 
In ordinary cases a drachm, three times a day, is the proper 
dose; but in obstinate eases it must be doubled. The best 
analysis makes the juice to contain acetate of potash, gallic acid, 
tannin, extractive, and water. It is believed that the remedy 
cures cutaneous affections dependent on a strumous diathesis, 
chiefly by its power on the kidneys as an eliminator and depu- 
rator. — Braithwaite, part xxix. p. 47. 

Gall^i. Galls. Nut- Galls. Oak Apples. — The last name 
is given to the galls when green. They are a peculiar kind of 
excrescence, formed by a small insect which deposits its egg in 
the tender shoots of the tree. When the maggot is hatched, it 
gives rise to a morbid growth of the adjacent parts, and after a 



476 NUT-GALLS. 

time it eats its way out of the nidus and escapes. The galls 
should be plucked before this, for when the insect has left its nest 
the gall is less astringent and less firm than before. The Aleppo 
and Smyrna galls are said to be the best because most astringent. 
The taste of galls is very astringent, and a little bitter ; exter- 
nally they are rough, and of a deep bluish-gray or olive color. 
The active soluble ingredients are tannic and gallic acids ; and 
as these are readily dissolved by water, we get the active pro- 
perties by making aqueous solutions. A drachm of coarsely- 
bruised galls added to six ounces of boiling water makes a good 
gargle for relaxation of the soft palate and uvula, and for 
general soreness of the fauces. In gonorrhoea and leucorrhoea 
the infusion of galls is sometimes employed, but is never safe if 
there be high inflammatory action. 

The ointment of galls has long been a popular application to 
hemorrhoidal tumors. The proportions are a drachm of the 
powder of galls to an ounce of lard ; and some add a half-drachm 
of camphor. A portion of the size of a nutmeg is to be ap- 
plied at bedtime, taking care to wash the parts well with warm 
soapsuds prior to each application. 

The powder of galls and gallic acid have been highly praised 
in the treatment of uterine hemorrhage. From five to eight 
grains of the acid joined to some aromatic may be given every 
three hours. 

Galls has been successfully employed in cases of purpura 
hemorrhagica in subjects varying from twelve to sixty years of 
age. Five-grain doses were given every three hours, and two 
compound rhubarb pills at bedtime. Not more than four scru- 
ples were required in any instance. — Association Med. Journal, 
Sept. 1853. 

Many years ago intermittens were treated with the ptfwder 
of galls combined with cloves ; but the practice fell into disuse. 

Two writers in the London Lancet for April, 1850, speak 
highly of the use of gallic acid in the treatment of albuminous 
urine, given in ten-grain doses every three, four, or six hours. 
It is conveniently administered in a little infusion of orange peel, 
or any other aromatic. The use of this acid for two or three 
weeks has sufficed. The precise modus operandi is not stated, 
but as the acid is easily detected in the urine it is to be inferred 
that the action is chemical and that .the blood is altered by it 
for the better. 

Gallic acid is also commended in the treatment of Asiatic 
cholera, by Dr. Nankivill, of Torquay, in the same journal. In- 
jections containing half a drachm of the acid with twenty drops 
of laudanum, in three ounces of starch, were thrown up the 
rectum after each evacuation, and five grains of the acid with a 



GARGLES. 



477 



sixth of a grain of opium were given in pill after each act of 
vomiting. External stimulation was employed at the same time. 

Christison designates gallic acid an internal or constitutional 
astringent, and notices its exhibition for the relief of mucus dis- 
charges from the bowels or urinary bladder. He says he has 
seen menorrhagia very promptly subside under its use, and he 
hints at its fitness for cases of albuminous urine. He calls three 
grains the usual dose, but says he has given thirty-six grains in 
twelve hours in urgent haemoptysis. 

A writer in Braithwaite, part xix., calls gallic acid the best in- 
ternal styptic, decidedly better than tannin. He gave it in five- 
grain doses two or three times a day, in mucilage or in pill. 

This acid is obtained from galls by slow oxidation of their 
tannin under the influence of atmospheric air and moisture, or 
more quickly by the oxidating agency of sulphuric acid. It 
may be given in quassia infusion, or in pills made up with con- 
serve of roses. 

Gargles. — This term is from a Greek word signifying I wash 
the mouth, and it means any liquid preparation to act on the in- 
ternal parts of the mouth and throat. Gargles are often very 
useful in relieving the throat and lessening inflammatory action 
of the fauces, tonsils, &c. The more important are the astringent, 
tonic, emollient, anti-scorbutic, and anti-scrofulous. 



Astringent Gargles. 

1. Take of alum, half an ounce ; 

Water, a pint. 
Mix. 

2. Take of nitrate of silver, gj; 

Water, ^ij. 
Mix. 

3. Take of strong vinegar, half a pint ; 

Powder of borax, half an 
ounce. 
Mix. 

4. Take of sugar of lead, a scruple ; 

Water, four ounces. 
Mix. 

5. Take of port wine, ^vi ; 

Tannin, £)j. Mix. 

6. Take of lemon-juice, four ounces ; 

Barley water, half a pint. 
. Mix. 

7. R. — Infus. rhatanias, ^vij ; 

Elix. vitriol, ^ss ; 
Syr. limon. gi. Mix. 

8. R. — Pulv. alum, sulph. 

Potass, nit. aa ^ss; 
" bitart. gij ; 
Acet. dist. 5 vi; dissolve and add 
Aq. rosar. "jtij. Mix. 



9. R. — Infus. rosar. ^viij ; 

Pulv. catechu, ^ij 5 
Elix. vitriol, ^i; 
Morph. sulph. grs. iv. 
Mix. 

10. R.— Sod. bibor. ^x; 

Pulv. catechu, gss ; 

" capsic. an. £)ij ; 
Mellis, ^ij ; 
Elix. vitriol, ^i ; 
Aquse, Oi. 



Mix. 



Tonic Gargles. 



1. R. — Infus. cinchona?, ^vi; 

Acid, hydrochl. ^ij ; 

Mellis, Sss. 
Mix. 

2. R. — Decoct, cinchonae, ^iv; 

Acid, hydrochl. ^iss; 
Infus. rosar. comp. ^iij ; 
Mellis, 5i. 
Mix. 

3. Take of decoction of Peruvian bark, 

eight ounces ; 
Lemon-juice, two ounces. 
Mix. 



4T8 



FORMULAE OF GARGLES — GENTIAN. 



4. Take of oak bark, 

Virginia snake-root, of each 

an ounce ; 
Boiling water, eight ounces. 
Mix. 

5. Take of Peruvian bark, two drachms; 

Tannin, a scruple ; 
Boiling water, eight ounces. 
Mix. 

6. Take of extract of rhatany, two 

drachms ; 
Peruvian bark, half an ounce ; 
Boiling water, a pint. 
Mix. 

Emollient Gargles. 

1. Take of powdered gum Arabic, half 

an ounce ; 
Slippery elm, an ounce ; 
Boiling milk, half a pint, 
Stew the whole for ten minutes. 

2. Take of sweet oil, four ounces ; 

Or as much butter ; 
Vinegar, half an ounce. 
Melt together, and use when warm. 

Antiscorbutic Gargles. 

1. Take of horseradish-juice, four 

ounces ; 
Vinegar, two ounces ; 
Peruvian bark, an ounce; 
Boiling water, a pint. 
Mix. 

2. Take of lemon-juice, two ounces ; 

Water, eight ounces. 
Mix. 



Antiscrofulous Gargles. 

1. Take of cod-liver oil, 

Vinegar, each, eight ounces. 
Mix. 

2. Take of hydriodate of potash, a 

drachm ; 
Water, six ounces ; 
Iodine, ten grains. 
Mix. 

3. Take of iodine of zinc, five grains ; 

Water, ten ounces ; 
Iodine, three grains. 
Mix. 

Cayenne Pepper Gargle. 
R. — Cay en. Afric. gij ; 

Aquse bullient. Oi. 
Digest for one hour, strain, and add 

Aceti fort. Sij ; 

Sodse mur. gi. 
Mix. 



R-- 



Mix. 



R 



Mix. 



Antiseptic Gargle. 
-Decoct, cinchon. grs. vi ; 
Pulv. camphor, ^i; 
Acid pyrolig. ^i. 



Chlorine Gargle. 
-Liq. chlor. sod. ^i; 
Mellis, 5ss; 
Aquae, 5yj. 



Saltpetre Gargle 
R. — Nit. potass, gij ; 
Oxymel scill. Ji ; 
Decoct, hordei, gvi 
Mix. 



Gentiana Lutea. Gentian. — This excellent bitter tonic grows 
in Switzerland, Austria, Burgundy, and North America. The 
active properties are soluble in water as well as in alcohol. 

The root is usually a little contorted, the epidermis wrinkled, 
and of a brown color. When broken the interior yellow color 
is manifest. The best quality of gentian is tough, flexible, and 
perfectly sound, having no trace of the depredations of worms. 
The perfection of the root for medicinal purposes requires the 
tree to be four years old. The name gentian is said to be de- 
rived from Gentius, King of Illyria, who employed it one hun- 
dred and sixty-seven years before the Christian era, to improve 
the appetite and promote digestion. The effect of gentian on 
the pulse is very feeble, although it enters the circulation. It is 
regarded as one of the best vegetable bitters, especially when 
combined with iron. 



USES OF GENTIAN — GERANIUM. 479 

Alcohol takes up the active properties of the root, and hence 
we have a tincture, which is made also with brandy and whisky. 
There is not an article connected with Materia Medica that has 
made so many drunkards as the tincture of gentian. It has 
been kept for centuries in grog-shops and regular taverns under 
the name of bitters, to be dealt out before breakfast, and at all 
times. As a medicine it is not called for by any contingency 
whatever ; and for all the purposes of a bitter tonic the com- 
pound infusion is far better. It is an excellent article for 
drunkards who are about to reform. To make it the following 
formula may be adopted : — 

Take of the sliced root of gentian, 

Orange peel, dried and bruised, each, an ounce ; 
Fresh lemon peel, two drachms ; 
Bruised cinnamon, a drachm ; 
Boiling water, twelve ounces. 

Macerate in a covered earthen vessel for one or two hours, 
then strain, and keep it in a cool place. The dose is a wineglass 
half-full several times a day. For feeble dyspeptics a scruple of 
calcined magnesia added to six drachms of the infusion and a 
drop of the oil of cinnamon will be found a very good medicine, 
to be taken at one dose and repeated two or three times a day. 
The best time for taking it is an hour before a meal. 

The extract of gentian, when well made, is an excellent medi- 
cine, and a good adjuvant for making pills of other articles. It 
is made by boiling a pound of gentian root in a gallon of water 
down to half a gallon, straining while hot, and evaporating the 
fluid to a proper consistence. Persons of delicate constitution, 
with heartburn and quite feeble, are relieved by two grains of 
the extract and two of carbonate of ammonia made into pill and 
taken three times a day. The proximate principle is called 
gentianine, but is not equal to a good extract. 

Geranium Maculatum. Cranesbill. — The root and pro- 
bably other parts of this plant were known to the Indians at a 
very early period as possessed of valuable astringent properties, 
which led to its use in dysentery and other affections. It is 
found in various parts of the United States growing in open 
woods, and flowering from April to June. Analysis shows that 
the root contains a good deal of gallic acid and tannin, with 
several other components that modify the astringency. 

As an astringent geranium is not very unlike kino and rhatany 
in its effects on the system. The late Prof. Barton spoke in high 
terms of its efficacy in cholera infantum, where its tonic and 
astringent powers .combined to give it effect. In many parts of 
the country the same use is made of this plant by the common 
people, who sometimes designate it as the alum root, because of 



480 NATURE OF GLYCERINE. 

its astringent likeness to alum. In ordinary sore mouth, sore 
throat, subacute inflammation of the fauces, &c, a gargle of the 
root is strikingly beneficial. The strongest infusion or decoction, 
or a diluted tincture of the root, may be employed for these ends. 
The internal administration may be in the form of powder or 
decoction or extract. The dose of the powder is from fifteen to 
fifty grains. The decoction, made with two ounces of the bruised 
root to a quart of water, boiled for half an hour, may be given 
in one or two-ounce doses. Two or three grains" of the extract 
will make a fair adult dose ; and the extract itself can be readily 
made by boiling half a pound in two quarts of water until a 
third of the fluid is lost, or even a half. The strained liquor, by 
evaporation, yields the extract. 

Glycerine. — This term is from a Greek word, and means 
sweet. It is the sweet principle of oils and fats, and acts in 
them as a base. It is gelatinous, and is left in the process of 
soap-making. The reputation it has acquired as a remedy for 
deafness is a principal reason for introducing it here. 

The mode by which it was procured at first for practical pur- 
poses is as follows : Digest equal parts of ground litharge and 
olive oil with a little boiling water, stirring, and adding water as 
it evaporates. When it is of the consistence of soft plaster it is 
to be well washed with hot water. Decant and filter ; then pass 
sulphureted hydrogen through the mass in order to throw down 
the lead ; after which filter and evaporate to a syrup in a water- 
bath. The syrupy product is glycerine, and looks a little like 
mucilage of gum Arabic. 

When perfectly pure and anhydrous, glycerine is almost color- 
less, of a sweet taste and syrupy consistence. It has a faint but 
not disagreeable odor, and a strong affinity for water, with which 
it readily combines. It unites readily with oils ; dissolves many 
gums and resinous substances ; does not crystallize nor ferment 
like sugar; will not evaporate beyond a certain point; and is 
finally destroyed by boiling. 

A very interesting paper in the Edinburgh Medical and Sur- 
gical Journal sets forth the solvent power of glycerine very ad- 
vantageously in respect of a large number of remedial agents, 
as the preparations of quinine, iron, senna, rhubarb, lemon-juice, 
cinnamon, cloves, &c. The solutions are very much in the nature 
of syrups, and the writer of the article is strongly impressed 
with the belief that alcohol and syrup will soon be superseded by 
glycerine. — American Druggists' 1 Circular and Gazette, July, 
1857. We have noticed these solutions already, and hold them 
to be valuable. » 

Mr. Startin, Surgeon to a London Hospital for skin diseases, 
published some notices of this article in the London Medical 



USES OF GLYCERINE. 481 

Times for August, 1847, from which we make a few extracts. 
He supposed that its antiseptic and uncloying properties would 
make it a valuable addition to poultices, lotions, baths, &c, all 
which would be rendered more emollient and soothing. These 
results followed the addition of an eighth, and even a sixteenth 
part of glycerine. Possessing the property of absorbing moisture 
from the air, it prevents the parts to which the applications are 
made from becoming too dry. Mr. S. says it is stimulant, anti- 
septic, demulcent, and may be a good substitute for sugar to 
sweeten food or drinks for invalids whose stomachs are injured 
by sugar. He has employed it in some shin diseases with de- 
cided benefit, such as pityriasis or dandriff, lepra, psoriasis, 
lichen, impetigo inveterata, and prurigo. He has found it use- 
ful in herpes exedens, and some syphilitic and strumous erup- 
tions. A sixteenth of a grain added to a few grains of borax 
and rose-water furnish one of the most elegant and efficacious 
washes for chapped hands, face, or nipples.* 

Glycerine applied to incipient boils seldom fails to effect their 
resolution. When pus is escaping freely, this article will facili- 
tate the healing process. Dr. Brinton had under his care an 
inveterate cracked tongue, which had baffled all attempts at 
alleviation for many years. It could not be referred to any 
syphilitic poison, and rendered eating, and especially speaking, 
very painful. Dr. B. made use of a favorite remedy of his 
in such cases, viz., borax dissolved in a lotion of glycerine 
(Price's Patent Candle Company's) and water — two scruples, 
one ounce, and four ounces respectively. It at once gave 
marked relief ; and after a few days, during which it was the 
only remedial agent, the improvement seemed increased by 
iodide of potassium and bark taken internally. The patient 
has now considered himself well, and discontinued the lotion for 
some weeks, and the cracks are only visible as depressions in the 
mucous membrane. — London Lancet, 1857. 

Some eight years ago Mr. Yearsley published his first ac- 
count of the benefit arising from the use of glycerine in deaf- 
ness, and others have called the attention of the profession to 
the remedy. That there is danger of the perpetration of a good 
deal of quackery as the result none can doubt. But as the 
article seems to be quite harmless, I see not why all deaf per- 
sons, whose organ of hearing is not absolutely destroyed by 
ulceration and exfoliation, may not give it a trial. 

The plan is to moisten wool with the glycerine, pure or diluted 
with water. The glycerine, having the power of absorbing mois- 

* R. — Pulv. bi-bor. sodse, grs. x; 
Glycerin, gr. i ; 
Aquae rosar. gi. Mix. 



482 USES OF GLYCERINE. 

ture, keeps the wool sufficiently moist to render frequent changes 
unnecessary. In some instances a few drops of the pure article 
have been let fall into the ear : from five to fifteen will suffice. 
Sometimes a solution of equal quantities of glycerine and water 
has been poured in, the patient laying the head down so as to 
favor the introduction of the mixture. 

The case of a barrister is reported who was very much relieved 
by this remedy, who had derived temporary relief before from 
the introduction of saliva by means of a quill. Others, who had 
tried oil of almonds with slight benefit, were signally relieved by 
the glycerine. As the glycerine has the power of dissolving 
gums and resins, it may be useful to remove hardened wax, and 
so relieve some cases of deafness. It is said to .act very happily 
where there is a deficiency of ceruminous discharge, by protect- 
ing the tympanum. And it seems to be a settled opinion that 
it is capable of affording relief in all cases where the patient is 
able to hear a watch pretty distinctly when it is pressed on the 
temporal bones. 

In the London Lancet for June 23, 1849, Mr. Wakley asserts 
that in several cases of deafness of very long standing, and in 
which the aural passage and tympanum exhibited a white, 
polished appearance, and the external meatus had become in- 
elastic, hard, and horny, and wholly deprived of the natural 
functions, the glycerine, patiently applied every day, had proved 
of the utmost advantage by restoring the parts to their natural 
condition and reproducing the ceruminous secretion of the organ. 

The same writer has a long article in the Lancet for Jan. 18, 
1851, in which many cases are detailed to set forth the value of 
this remedy. The subjects varied in age from six to seventy years. 

Our own experience, limited to be sure, has not been very 
favorable. Still, we say, give it a trial. 

The nutrient powers of glycerine have been tested by Dr. 
Lindsay, as we learn by the British and Foreign Medical and 
Chirurgical Review for January, 1857. He took two or three 
teaspoonfuls daily for several weeks, and gained two pounds in 
weight at the end of four weeks. After discontinuing its use, 
the weight gradually fell. The most palatable mode of taking 
it is with coffee. It serves to sweeten in place of sugar, and if 
the taste be unpleasant a little sugar may be added. It may be 
added to tea, and it sweetens milk and cream very pleasantly. 
Its mixture with water is also palatable, and this is the readiest 
and cheapest mode. 

Dr. Lindsay further regards glycerine as a valuable basis for 
expectorant and demulcent mixtures. He thinks that all our 
tonics and alteratives might be administered most agreeably in 
this article. 



GRUEL — GUAIACUM. 483 

The endermic use of the iodide of glycerine has been highly 
praised by Dr. Szukits, who has often employed it, as we learn 
from the journal referred to above. 

Gossypium Herbaceum. (See Cotton.) 

Grocer's Alum. (See Potash.) 

Gruel. — This is usually regarded as a watery solution of oat- 
meal, and we spoke of it under the head Avence Farina, which 
the reader can consult. But in some parts of our country oat- 
meal is seldom seen, and in place of a gruel made of it, there 
is what the people call corn gruel, or a gruel made of ground 
Indian-corn. It is prepared very much after the manner pointed 
out for the other kind of gruel, and is an agreeable, simple, un- 
offending sort of diet, rarely acting unpleasantly unless eaten to 
excess. It can be made very tasteful by the addition of lemon 
or ginger syrup. 

Guaiacum Officinalis. Lignum Vita?. Wood of Life. — 
The raspings or turnings of the wood and the resinous matter 
usually called guaiacum are employed in practice. Decoctions 
of the wood and other vegetable matters are occasionally re- 
sorted to, and when long administered are held to possess altera- 
tive properties. 

The resinous matter is usually called a body, sui generis, the 
precise nature of which is not well understood. The name gum 
guaiacum is not correctly applied, and yet it is perhaps better 
known by that title than by any other. It is seen in masses, 
easily broken, and presenting a greenish-brown aspect. It has 
very little smell or taste, and the fine powder is of a pale-green, 
which becomes dingy by exposure to the air. 

Formerly guaiacum was held to be a valuable medicine in the 
treatment of secondary syphilis, and the decoction of the wood 
was employed in this relation as well as the resinous matter. 

More extensive use has been made of this article in the treat- 
ment of rheumatism than for any other purpose, so that in many 
places it has become a domestic remedy. The adult dose of the 
powder is from fifteen to thirty grains three times a day, with 
or without diaphoretics. The powder is sometimes taken in 
milk, but the color of the mixture is objectionable, and to avoid 
this, syrup should be selected as the vehicle. A mixture of 
fifteen grains of the powder and ten of Dover's powder, taken 
at bedtime, has been a popular mode of administration. In ad- 
dition to the internal use, some persons think they have been 
much benefited by the alcoholic solution applied as a lotion to 
painful parts. 

M. Pereyra, of Bordeaux, speaks very favorably of the fol- 
lowing prescription for rheumatism : — 



484 GUNPOWDER. 

Take of guaiacum, in powder, a drachm ; 

Orange leaves, in powder, half a drachm ; 
Acetate of morphia, three-quarters of a grain. 

Mix well, and divide into sixteen powders, one of which to be given every two 
hours. (See London Lancet, August, 1843.) 

The simple and the volatile tinctures of guaiacum have been 
also employed in rheumatic affections, but I have never regarded 
them as sufficiently important to give them a trial. The simple 
tincture may be made by adding from one to three ounces to a 
quart of brandy. The ammoniated or volatile tincture is made 
by adding four ounces of the powder of guaiacum to a pint and 
a half of the aromatic spirit of ammonia, digesting for fourteen 
days and filtering. The dose is from half a drachm to two 
drachms three times a day. The late Professor Dewees regarded 
the volatile tincture as a good medicine m amenorrhoea. 

The most novel use of guaiacum was reported in the New York 
Journal of Medicine for November, 1848, by Dr. Sterling, of the 
Marine Hospital, at Staten Island. He gave it in acute dysen- 
tery ; first in ten-grain doses three times a day, with some mu- 
cilaginous liquid, and afterward according to the following 
formula : — 

R. — Pulv. guaiac. gv; 

Muc. gum Arab. 

Syrup simp, aa ^iij ; 

Aquae, ^viii. 
Mix. 

The dose of the mixture was two ounces three times a day or 
every six hours, carefully shaking the bottle before using it. The 
diet of the patients was farinaceous. In four or five days the 
disease generally disappeared. 

A still more novel, use (at least to us) has been reported in 
the London Lancet of April 4, 1857, by Dr. Brinton. He has 
treated cynanche tonsillaris with this remedy at the Royal Free 
Hospital, and says he has employed it for many years. He re- 
gards the tonsils as an offshoot of the intestinal canal, and thinks 
that constipation is a frequent accompaniment. He gives the 
powder of guaiacum, in doses of a scruple and from that to a 
drachm, every four hours, sometimes mixed with aloes, jalap, 
and opium, the whole being blended together by mucilage. The 
design of the guaiacum dose is to effect purgation freely. Dr. 
B. asserts that if this treatment be adopted early, the re- 
covery will be rapid and the exemption from another attack 
more certain than it is under the ordinary mode of treat- 
ment. — London Lancet, April, 1857. 

Gunpowder.— Dr. Dick, of Glasgow, has called the special 
attention of medical men to this new remedy for dyspepsia. He 
found it very useful as a corrective of morbid secretions of the 



GUTTA PERCHA. 485 

gastro-mucous membrane, dependent on subacute inflammation 
or accompanied by it. He gave it in ten-grain doses several 
times a day, and gradually increased, occasionally interposing a 
mild laxative. Spirituous liquors and pungent condiments were 
forbidden during its exhibition. 

Dr. Dick thought that the good effects of the medicine de- 
pended on the detergent properties of the charcoal and nitre that 
enter the composition of gunpowder ; and he affirms that it is a 
perfectly safe medicine. It is one of the articles which chlorotic 
girls eat with avidity, and unless eaten to excess might not be 
injurious, (For further hints, see Dick On Digestion.) 

G-UTTA Percha. — This article has elicited so much of the at- 
tention of medical men that it would not be right to omit a notice 
of it in this work. 

It is the native name of the exuded juice of a tree, so-called, 
indigenous to Singapore and its vicinity, and gathered like 
caoutchouc, to which it has some resemblance. It is imported 
in lumps or masses, and at the ordinary temperature feels quite 
hard, but becomes soft and pliant when plunged into boiling 
water. When soft it can be rolled out and moulded into any 
shape, which it retains when it becomes cold. 

Besides its adaptation to a hundred domestic and mechanical 
uses it is also susceptible of extensive application to the purposes 
of surgery and obstetrics. Splints, bougies, injection-pipes, and 
catheters have been formed out of it, and more recently it has 
been employed in the manufacture of pessaries, nipple-shields, 
artificial teats, handles of forceps, &c. Dr. Simpson, of Edin- 
burgh, had a very neat speculum uteri made of this material ; 
and it is not improbable that almost every sort of instrument, 
excepting those with sharp edges, will ere long be obtained from 
the same source. 

Mr. Beardsley, a surgeon in Derbyshire, England, has pre- 
pared an article for the arrest of hemorrhages supervening the 
extraction of teeth, which is made as follows : — 

Take of gutta percha, an ounce ; 

Best tar, an ounce and a half; 
Creosote, a drachm ; 
Shell-lac, an ounce. 

These are to be boiled in a crucible, well stirred or beaten till 
blended into a stiff, homogeneous mass. The compound is readily 
softened between the fingers, and is easily introduced into the 
bleeding socket. The hemorrhage is speedily checked. (See 
London Lancet, May, 1850.) 

The common paste of gutta percha, such as shoemakers use, 
has been applied very happily in the treatment of erysipelas. It 
acts by excluding the air from the inflamed surface, as it would 



486 LOGWOOD — DRY CUPPING. 

also in burns, wounds, ulcers, &c. The paste is applied by the 
finger, being first heated, and then the common gutta percha 
tissue is laid over the whole. — Edinburgh Medical Journal, 
December, 1855. 

A solution of gutta percha has been employed in swelled testicle 
and fresh wounds, on account of its adhesiveness and making an 
air-tight covering. The gutta percha is dissolved in bisulphuret 
of carbon and the solution spread over the affected part. It be- 
comes dry speedily, forming a thin, tight, and adhesive coat, 
which loosens at the edge after three or four days, when it should 
be repeated. 

It is stated that seven grains of gutta percha dissolved in one 
drachm of chloroform will give a more adhesive dressing than a 
solution in collodion, which some persons employ. 

M. Robiquet has prepared a useful caustic by mixing together 
equal parts of softened gutta percha and melted hydrate of pot- 
ash or chloride of zinc. The mass may be moulded into any 
desired shape so as to be applicable to wounds, fistulas, &c. &c. 

One drachm of gutta percha, softened with hot water, worked 
up with catechu powder and tannic acid, each half a drachm, 
adding a drop of some essential oil, will make a good cement for 
filling cavities in teeth. A morsel is to be softened over the 
flame of a spirit-lamp, and properly fixed in the cavity while 
warm. The mass becomes very hard in a short space, and after 
the lapse of months is not decomposed. — Revue Medicale, 1857. 

Hematoxylin Campeachianum. Logwood.— The well-known 
astringency of this article entitles it to a place in Materia Me- 
dica. The decoction when properly prepared is a palatable and 
useful medicine, that has been much employed in diarrhoea and 
in the last stage of dysentery. In the diarrhoea of hospitals 
there can hardly be a better remedy. We find great relaxation 
and debility of the bowels, frequent and copious discharges that 
are quite exhausting. To meet such cases, prepare a decoction 
by boiling two ounces of rasped logwood in a quart of water for 
fifteen minutes, and add to the clear liquor sufficient nutmeg 
and white sugar to make the whole pleasant. A wineglassful 
may be given from four to eight times a day. The extract, 
which can be had in the shops, is also a good article, and may 
be given for the same purpose, in the dose of ten to twenty 
grains in syrup three times a day. 

Patients should be informed that the medicine always gives a 
blood-red color to the stools, otherwise they may be needlessly 
alarmed. 

Logwood is incompatible with chalk and lime-water, and there- 
fore mixture with either should be avoided. 

Hemospastic Medication. — Anything capable of drawing 



HEMOSTATIC. 487 

blood to a part may be said to act haemospastically. Dry cup- 
ping does so unquestionably, and thus proves a valuable remedy. 
It not only draws blood from internal parts to the surface, but 
it attracts morbid action in the same way, and so affords relief. 
I have known dry cups to give signal relief to persons laboring 
under great gastric and intestinal suffering that did not warrant 
depletion. Common half-pint tumblers will answer for adults 
very well, in lieu of ordinary cupping-glasses. A piece of paper 
rolled up and fired, and dropped into the tumbler and allowed 
to burn a minute or two, fits the tumbler for application to the 
spot. One, two, or more may be applied, and repeated as often 
as may be desirable. They should remain until ready to fall off. 

The importance of this practice is happily illustrated by M. 
Condret, in an article published in the Encyclograph 31edicale, 
1848, on the use of cupping-glasses to the spine in intermittent 
fever. The following is his method, and which he declares 
never failed to cure. He applies eight or ten middle-sized cup- 
ping-glasses on each side of the spinal column from the neck 
downward, allowing them to remain for about thirty or forty 
minutes without scarification. He applies the cups at the 
beginning of the cold stage, or a very short time before its ac- 
cession. This not only keeps off the chill, but prevents the hot 
and sweating stages also. Generally, one application of the cups 
suffices, but in old cases they must be applied three or four times. 

He declares that in his own private practice during the last 
twenty-seven years he has not met with a case of intermittent 
fever which did not yield to this treatment. The vacuum pro- 
duced along the vertebral column is supposed to operate as a 
salutary derivative, and thus to accelerate the cure. 

I have known the same practice to give relief to persons 
laboring under difficulty of respiration induced by congestion 
of the lungs or the mucous membrane of the bronchi; while 
the cups were on, and afterward, the embarrassment of the 
chest was very much abated. The practice is too little in use. 
It is essentially a variety of revulsive treatment. 

Haemostatic. — This term comes from two words meaning to 
stop the flow of blood. The word styptic is often used in its stead. 

All active astringents are more or less haemostatic or styptic, 
and this has been noticed repeatedly elsewhere in this volume. 

Pagliaris hemostatic has excited so much interest abroad 
that we give it a place here. It is made thus : — Eight ounces of 
tincture of benzoin, one pound of alum, and ten pounds of water 
are boiled together for six hours in a glazed earthen vessel, con- 
stantly adding water to supply the waste by evaporation ; and 
the whole should be well stirred frequently. Filter the fluid, and 
keep it in stoppered bottles. It is limpid, styptic in taste, aro- 



488 WITCH-HAZEL — UNICORN PLANT. 

matic, and of the color of champagne. Its potency is undoubted. 
Bull, de Therap., vol. xii. p. 491. 

Hamamelis Virginiana. Witch-hazel Spotted Alder. 
Winter Bloom. Snapping Hazelnut, &c. — A very bold effort 
has been made to force into public notice an article called 
Pond's vegetable pain extractor, said to be prepared from the 
witch-hazel. We shall refer to this hereafter.* 

While residing in the western country I became acquainted 
with the use of this plant by the steam-doctors, some of whom 
are exceedingly partial to it. In Howard's Improved Botanical 
Medicine it is named with commendation, as an astringent tonic 
and styptic. The writer says, "It may be employed as a tea 
for bowel complaints, bleeding at the stomach, lungs, and all 
internal hemorrhages. As a styptic to check internal bleeding 
the witch-hazel is among the best articles known. Poultices 
of the bark are also applied to painful tumors and external in- 
flammations." 

The above is quite as much as should have been affirmed by 
any one touching this plant; and very probably it has some 
claims to notice in the above relations. But the vegetable pain 
extractor takes a much wider range. It cures burns and scalds, 
wounds, old sores, bruises, broken limbs, weak or lame back, 
sore or inflamed eyes, all internal inflammations, quinsy or sore 
throat, local pains, all internal bleedings, piles, colic, cholera 
morbus, all boivel complaints, headache, rheumatism, ague in the 
face, and it quiets the nerves. Such is the statement on the 
label placed on each bottle of the medicine, which would seem 
to be a double distilled extract of the whole Materia Medica. 
What need of more articles for the practice of physic than 
Pond's vegetable pain extractor? and why need any one die 
when such a panacea can be had for twenty-five cents ? 

The witch-hazel is a very common plant in this country, 
growing from ten to twenty feet high, with large, smooth, alter- 
nate, oval leaves. The flowers appear after the leaves fall, and 
the fruit ripens in the autumn. It grows on hills, mountains, 
stony banks, and near to streams. 

Hellebore. (See Veratrum.) 

Helonias Dkeca. Unicorn Plant. Blazing Star. Star- 
root. BeviVs Bit. — Of this plant I know nothing personally. 
Dr. Braman, in the Boston Medical and Surgical Journal, has 
noticed it as being an invaluable remedy for leucorrhoea, and 
having no equal in the Materia Medica. He holds it to be 
especially suited to such affections as have their origin in atony 
of the generative organs of both sexes, but particularly those 

* Pond's Pain Extractor prepared the way for the popular Pain Killers of the 
day, which belong to the same humbug family. 



hops. 489 

of the female. Under its influence the patient whose life has 
been a burden soon revives. Her uncomfortable sensations 
vanish, and ultimately entire recovery is realized. Such is the 
commendation of this plant. Dr. B. regards the syrup as the 
most eligible mode of exhibition, but names also the powder and 
tincture. The doses are as follows : — Of the powder, a drachm 
and a half; of the tincture, a drachm; of the syrup, three 
drachms. These are to be taken three times a day, half an 
hour before the ordinary meals. The doses may be increased 
according to circumstances. In irritable stomachs the medicine 
is apt to induce nausea, and when that effect is realized the dose 
must be reduced. 

In Dr. Bigelow's recent pamphlet on the Medical Botany of 
Ohio, I find a very brief notice of this plant. It is there called 
an acrid medicinal, an anthelmintic and tonic, and that is all. 
In Hoioard's Botanic Medicine, page 285, where it is called 
Unicorn, Star-root, Blazing Star, and fully described, it is said 
to be a remedy for colic, strangury, rheumatism, jaundice, coughs, 
consumption, &c. &c. The author notices its power to prevent 
abortion and restore suppressed menstruation. The two effects 
last named agree with the suggestions of Dr. Braman. The 
dose named by Howard is half a teaspoonful of the powdered 
root three times a day, in a gill of warm water. The constant 
use of it makes the mouth sore. 

Homoeopathy. (See Infinitesimal Practice.) 

Humulus Lttpulus. The Sop. — This article is so well 
known to all Americans that it would be a waste of time to 
attempt a description. The vine called hop vine is seen in 
almost every garden, and is held to be an essential part of do- 
mestic economy in many places. The peculiar odor, the aro- 
matic and bitter taste, are known to all. The hops contain a 
large quantity of lupuline, which is not, properly speaking, a 
proximate principle. This, as well as the hops, yields its active 
properties to water, and better still to alcohol or proof spirit. 
The latter is generally employed for making the tincture of 
hops, though some prefer old wine. Five or six ounces of hops 
and a quart of proof spirit or wine make a good tincture. They 
should be digested for two weeks, and then strained or filtered. 
The infusion of hops is made by adding half an ounce to a 
pint of boiling water ; maceration for two hours in a covered 
vessel and straining fit it for use. The extract can be pre- 
pared from the strongest infusion by slow evaporation of the 
filtered liquor. The usual adult doses are as follows : — From one 
to two fluidrachms of the tincture, from one to four ounces of 
the infusion, and from three to fifteen grains of the extract. 

Hops and the preparations above named were formerly much 

32 



490 MERCURY. 

in use, but of late they are rarely administered. A hop pillow 
is a very old expedient for procuring sleep, and is certainly a 
safe prescription. For nervous persons it often answers very 
well, because it satisfies them that something is done; and if 
they desire it, never refuse. 

The therapeutic uses were formerly various. I have employed 
hops as a substitute for opiates in persons to whom the latter 
were not well suited by reason of existing disease or constitu- 
tional peculiarity. But now that we have the pleasant salts of 
morphia, we can well dispense with the preparation of hops. 

From fifteen to thirty grains of lupuline, triturated with white 
sugar, make a dose for the treatment of chordee, priapism, and 
spermatorrhoea. It is called an anaphrodisiac in consequence 
of this application. M. Ricord and others have increased the 
dose to two or three drachms without any inconvenience. — Lon- 
don Lancet, July, 1853. 

Hydrargyrum. Quicksilver. Mercury. — The word hydrar- 
gyrum comes from two Greek words which mean water and 
silver, indicating the fluidity and silvery appearance of the 
metal. It was called quicksilver because of its great mobility, 
and mercury in honor of a heathen deity. It is found in the 
fluid state, blended with some impurities, and also in various 
forms of chemical combination. At 39° below zero it becomes 
solid, and hence the mercurial thermometers belonging to Capt. 
Ross, in the northern regions, were destroyed, as his work in- 
forms us. At 600° Fahr. it is converted into vapor, or sub- 
limed. And yet something like evaporation occurs in the holds 
of ships when mercury bottles leak and the metal escapes 
largely. Whole crews have been profusely salivated by such 
accidents, and even the rats have felt its influence, being de- 
stroyed in large numbers. This circumstance led Mr. Faraday 
to institute a series of experiments, of which the following is a 
sample: — He took a salt-mouth bottle and suspended at the end 
of the stopper a slip of gold-leaf two or three inches long, the 
bottom of the bottle being covered with mercury. The bottle, 
with its stopper well adjusted by means of a little grease, was 
placed in a secure position, and remained undisturbed for some 
weeks. On being examined, it was found that the gold-leaf was 
perfectly amalgamated at the ordinary temperature. Here was 
something not unlike the fact mentioned in respect of mercury 
in a ship-hold, no matter whether we call it evaporation or by 
some other name. It may throw additional light on this point 
to state, on the authority of Dr. Christison, that mercury is 
slightly oxidizable at 60° Fahr. 

The sad effects of mercury on those artisans who gain a live- 
lihood by silvering mirrors deserves a passing notice; and to 



MERCURIAL POISON. 491 

make the subject practically interesting, we quote the following 
remarks from the excellent work of Thackrah On Arts, Trades, 
&c, page 112: — 

a Peter Cataneo, an Italian, had worked for five years at the 
business of silvering mirrors, and was frequently compelled to de- 
sist from the employment until the effects of the mercury sub- 
sided. At length his tremors became general : gums sore, spirits 
depressed, bitter taste in the mouth, tongue white, pulse quick 
and small, but difficult to be felt on account of the constant 
tremor ; cough and tightness of the chest, heat of skin above the 
natural standard, &c. He took sulphur, as practiced at the 
mercurial mines, with some little benefit ; a grain of opium at 
bedtime ; and for diet, milk, gruel, fish, and porter. For his 
sore mouth, an acid gargle was employed. The ptyalism abated, 
the tremors subsided, and in the course of a fortnight nearly dis- 
appeared, leaving, however, a sad feeling of weakness, which was 
successfully managed by generous diet and bark. He was en- 
joined never to resume the occupation of silvering again, but he 
did not take advice until compelled by the necessity of the case 
to do so. 

" Another case is detailed in which the speech was greatly im- 
peded, the limbs tottered, and the man, though young, moved 
like one far advanced in years. He could not convey any liquid 
to his mouth in consequence of the severity and constancy of the 
tremors. His appetite fell off, his sleep was greatly disturbed, 
his body wasted, and the lungs dreadfully oppressed. So great 
was the violence of the trembling of his whole frame that he was 
nearly thrown out of a bath by it. Much of the water was 
driven over the sides of the tub, and it required the force of two 
men to prevent him from being actually ejected. 

" This distressing disease, though most frequently seen by the 
French, is sometimes met with in this country. The French call 
it mercurial trembling . It is, in fact, a kind of palsy, and abso- 
lutely incurable, except by abandoning the trade, and not always 
even then." 

Mr. Mitchel, of London, who furnished the cases from which 
the above remarks are extracted, observes that in twelve looking- 
glass manufactories he visited, "It clearly appeared that the 
metal became oxidized by combining with part of the oxygen of 
the atmosphere, and the more quickly so from the friction neces- 
sary in the application of the mercury to the plate of glass." 
And to show how this heavy metal can be affected by causes that 
some would deem inadequate to the result, it is stated by a su- 
perintendent of. a silvering factory, " That from the sweepings of 
the chimneys, on one occasion, he collected twenty pounds of good 
quicksilver.'' 



492 ALTERATIVE ACTION OF MERCURY. 

It is proper to notice a supposed mode of poisoning in which 
quicksilver is implicated. It is effected by the administration of 
the scrapings of an old or broken looking-glass; and in many- 
places it is believed that true poisoning is thus accomplished. 
Now the article in question is an amalgam of tin and mercury, 
and, unless some more deleterious agent be present, we do not re- 
gard the compound as a true poison. If given in large quan- 
tity it may sicken and vomit, and such are the effects as com- 
monly reported. "We never heard of a death from this alleged 
agency. 

Mercury as such, uncombined and unchanged, has been occa- 
sionally employed as a remedy. Pound doses were formerly ex- 
hibited to overcome obstinate constipation, and although some- 
times successful, death not unfrequently resulted in consequence 
of rupture of the bowel and peritoneal inflammation ensuing. 
The practice was justly laid aside, because it is not possible to 
know certainly whether there is or is not a tender spot in the ali- 
mentary canal that may be forced, by the weight of the metal, so 
as to induce perforation. The Germans were partial to the water 
of mercury, as some call it, as an anthelmintic. They boil the 
metal in pure water, and filter, believing, of course, that ebulli- 
tion enables the water to take something from the mercury that 
is truly medicinal. But, as the metal weighs precisely what it 
did prior to ebullition, it is manifest that the idea of remedial 
qualities in the 'water is purely a German affair. 

The alterative action of metallic or fluid mercury has long been 
entertained by those who resort to various internal means to im- 
prove the complexion. In fact no such result could be had from 
any internal agent, apart from this alterative action. It is re- 
lated that the beauties of the Court of Charles the Second were 
in .the practice of employing mercury for this end. They took a 
teaspoonful night and morning, for some time previous to a 
splendid fete, when they would have a fine opportunity for dis- 
play. After a reiterated dancing exercise in the great saloon, 
lit up resplendently with a thousand burners, it was observed that 
a million or more of mercurial gems were sparkling on the floor 
in every direction, having dropped from the bowels of the fair 
ones during the agitation of their persons. One of the first 
duties of the servants on the next day was to gather up these 
fragments, and, after careful washing, the mass was preserved for 
future use on like occasions. 

Mercury, as imported and sold, contains some impurities which 
may be separated by a sort of filter made of a paper cone and 
punctured at the apex with a pin ; the pure mercury passes 
through this small aperture, and the foreign matter is retained on 
the paper. It is also obtained in the fluid form by decomposi- 



OXIDES OF MERCURY. 493 

tion of the native sulphuret by the agency of iron filings. The 
heat required volatilizes the mercury, whose vapors are condensed 
in a receiver kept cold. 

Fluid mercury is found in the human economy so often that a 
careless observer might infer the source to be a natural one. 
Whenever so discovered, it is in consequence of the previous use 
of some mercurial medicine as a remedial agent. In the bones, 
the liver, the saliva, the pus of buboes, and in many other loca- 
tions, globules of mercury have been frequently detected. The 
London Medical Gazette for 1847 informs us that a man who had 
a bubo was directed to rub in several ounces of strong mercurial 
ointment, as had often been done before. On opening the tumor, 
the pus was collected and analyzed, and quicksilver was found in 
it. It is not said whether the man took mercury internally, al- 
though it is probable he did. In all cases where this metal has 
been found in the body after death, excepting in those in which 
the metal was exhibited as such, it is fair to conclude that the 
mercurial medicine was decomposed by the vital forces and the 
metal thus separated. This is the only philosophical conclusion 
we can reach. 

We propose to consider the oxides of mercury first, and to 
notice their practical uses. And it is well to notice here the 
declaration of Christison in his Dispensatory, that mercury is 
susceptible of oxidation at the ordinary temperature. This has 
not generally been believed, and it would seem that some mistake 
may have been blended in the announcement, or that the oxida- 
tion is exceedingly imperfect. It is known that many regarded 
the Ethiops per se of Boerhaave as a true oxide of mercury, al- 
though nobody holds that view of the case now. It was formed 
by long agitation of mercury in a bottle partly full. A fine black 
matter was thus obtained, supposed to be mercurial oxide, but 
now regarded as an impure oxide of other metalic matter, acci- 
dentally present. 

The recognized oxides are the protoxide and peroxide, both 
having important therapeutic relations. These differ in the rela- 
tive proportions of oxygen, and in nothing else. The equivalent 
of mercury being called 200, there is 1 equivalent, or 8 of oxy- 
gen in the protoxide, and 2 or 16 in the peroxide. 

The red oxide of mercury has been used for the last twenty 
years by Mr. Lloyd, of St. Bartholomew's Hospital, for the cure 
of hydrocele. One grain is injected through a canula, passing it in 
by means of a probe. It has never failed to cure in a single in- 
stance. — Lon. Lancet, Feb. 14, 1857. It would have been well 
to have been a little more explicit about the introduction of the 
oxide. 

Of these oxides the protoxide is, medicinally, more valuable 



494 BLUE MASS AND OINTMENT. 

than the other. It may be made by adding the chloride of mer- 
cury or calomel to a solution of potash or lime in water. Muriate 
of potash or lime is formed, and protoxide of mercury falls. 
The precipitate should be repeatedly washed in pure water, well 
dried, and kept in vessels excluded from air and light. The pro- 
duct is commonly called the black oxide or ash-gray oxide, and 
may vary in this respect, from unforeseen contingencies. Car- 
penter's black oxide was prepared substantially in this way, and 
from it the well-known blue mass and mercurial ointment have 
often been made. A fourth of a grain of good black, or pro- 
toxide, is equal to a whole grain of blue mass made after the old 
plan. There can be no doubt in regard to this preparation that 
the mercury is chemically changed, and not mechanically divided, 
as it is alleged to be in the old-fashioned blue mass. If the lat- 
ter be properly made, as it may be, there is more than mere 
mechanical division ; for you cannot easily detach any mercurial 
globules by rubbing it with boiling water. But, as it is often 
made, there is not even a good mechanical separation of particles, 
because the trituration is brief and imperfect. In the use of the 
protoxide of Carpenter, we can form the mass and the ointment 
much more speedily than by the old methods ; and this is an ob- 
vious advantage and clear gain. To make the one or the other 
as it was always made forty years ago, demanded at least an 
hour's labor for a single pound. By the use of the protoxide a 
pound can be had in ten minutes, and of a decidedly better 
quality. 

To make blue mass after the way of the olden time, two 
drachms of fluid mercury, three of conserve of roses, or honey, 
and one of powdered liquorice root were directed to be thoroughly 
incorporated, the liquorice being added last. Even for so small a 
quantity an hour's rubbing will not be too much, as I know by 
experience, for I have performed the task more than once. But 
if you take a grain of the protoxide and rub it with three of con- 
serve of roses, you have an equivalent of four grains of common 
mass in three minutes. The protoxide rubbed with lard, gives 
you at once a good ointment ; but formerly, a long trituration of 
two pounds of mercury, twenty-three ounces of lard, and one of suet 
yielded an article certainly no better, and frequently quite inferior.* 

* The following direction, furnished by Mr. Stoddart, for the easy and rapid 
preparation of blue mass, merits attention. A pound may be obtained in an 
hour so perfect that not a metallic globule can be seen with a Coddington lens. 
" Rub the mercury with powdered liquorice (adding a little pure water or rose- 
water occasionally) till all the globules disappear. Then add the usual quan- 
tity of confection of roses, and mix the whole thoroughly. The rapidity with 
which the liquorice 'kills' the mercury will astonish anyone who has been 
used to the old plan of rubbing the metal with the conserye of roses." — Dublin 
Hosp. Gaz., February, 1855. 



BLUE MASS AND OINTMENT. 495 

The medicinal uses of blue mass and blue ointment, as it has 
been called, are numerous and valuable. The alterative action 
of the blue mass, so forcibly inculcated by Abernethy, is every- 
where appreciated, and probably will ever continue to be. It is 
an excellent medicine, and could not well be dispensed with. An 
obvious advantage it has over other mercurials is, that it seldom 
disagrees with the alimentary canal, and can therefore be admi- 
nistered long enough in nearly all cases to secure its complete 
alterative operation. In this regard the dose need not be over 
one or two grains every night; but if desired to act on the 
bowels, from three to five grains may be taken and repeated. 
The blue mass with ipecacuanha (one grain of the former and 
three of the latter) will be found an excellent medicine in many 
cases of derangement of the boivels. The dose should be given 
every four hours. 

The black oxide, not in shape of mass, has been successfully 
administered to check vomiting of pregnant females, by Dr. 
Stackler, of the Lower Rhine. The dose was a grain daily, and 
continued until relief was obtained. It is stated that salivation 
did not ensue. (See Gazette Medicate, of Strasburg.) 

In all these uses of blue mass or black oxide the liver is 
generally at fault, being in a torpid state. The stools are soon 
made much darker colored, and this is a signal of manifest im- 
provement. 

The ointment is now employed only as an external remedy, 
though formerly it was given internally in large bolus, to cure 
syphilis. (See London Medical and Physical Journal, vol. ix. 
page 487.) In the act of rubbing mercurial ointment into the 
surface the operator usually guards his hands by means of a 
glove or bladder ; and even with all his care salivation occasion- 
ally follows, most probably from inhalation of the vapors. This 
inunction is made commonly as an aid to the internal exhibition, 
so as to put the system under the mercurial influence as soon as 
possible. A case of hydrocephalus acutus, supposed to be hope- 
less, was treated with this anointing process over the entire 
body, which was then wrapped in a blanket. The child recovered, 
and the result was attributed to this heroic treatment. Not a 
trace of salivation followed, nor is this necessary at all to a true 
mercurial impression. The gold watch and gold coin in the 
pockets of persons long under the use of mercury have been 
coated over with an amalgam, although the mouth was not 
touched. Facts like this prove that the old practice of profuse 
salivation was wholly unnecessary, as the constitutional effect 
can be secured independently of the slightest flow of saliva 
beyond what nature demands. This is an instructive lesson. 
Heed it. 



496 RED PRECIPITATE. 

A very happy use of mercurial ointment is in the treatment 
of paronychia, or whitlow, as stated in the Medico- Ghirurgical 
Revieiv, July, 1845. Rub on the part affected every other five 
minutes, for two hours, night and morning, a portion of strong 
ointment. Over this lay a soft poultice of bread and milk, or 
mush. Suppuration is prevented and very sensible relief soon 
realized. 

The theory of inunction of mercurial ointment is often dis- 
cussed, and yet it is not very important. Some contend for di- 
rect absorption, and others for inhalation of the vapors. That it 
may act by its impression on the nervous system is undoubted, 
and the inhalation of the vapors is sustained by the. well-known 
practice of salivating venereal patients in hospitals by means of 
the fumes of cinnabar. This was done in the Pennsylvania Hos- 
pital when I was a pupil. 

But we have to name another mode of using the protoxide of 
mercury, viz., in the shape of the hydrargyrum cum creta, or 
mercury with chalk. This is an excellent preparation, and often 
preferable to calomel. It may be made by triturating three 
ounces of mercury with five of prepared chalk until the globules 
wholly disappear. The metal, in whole or part, is changed into 
protoxide in the act of preparation, if well done. The medicine 
is well suited to infantile diarrhoea and cholera, and I have used 
it satisfactorily as an alterative, for the cure of skin diseases, and 
especially crusta lactea or milk blotch. This very distressing 
and sometimes obstinate disease is treated best with very few ap- 
plications to the surface, and with special attention to the di- 
gestive organs. Tepid milk and water, or Castile soapsuds, or 
a very weak solution of chloride of lime, or chloride of soda, 
will prove far better than all the ointments in the land. From 
a half to two grains of the hyd. cum creta three times a day, 
for children between one and three years old, should be given 
for one, two, or three weeks, according to the circumstances 
of each case. Signs of improvement are soon apparent under 
this treatment. 

The peroxide or red oxide of mercury is less frequently em- 
ployed than the protoxide. Two varieties of this oxide have 
been named, differing obviously in the shade of color, and also in 
their therapeutic relations. The red precipitate, as it is called, 
and the precipitate per se are the articles referred to. They are 
the products alike of mercury, but the former is made by the aid 
of an acid also ; the latter without such help. 

To get the red precipitate dissolve three parts of pure mer- 
cury in four of dilute nitric acid, (equal weight of acid and 
water ;) evaporate to dryness, reduce to a fine powder, and expose 
to a stronger heat till a red color appears. A yellow nitrate is 



CALOMEL. 497 

first obtained, with copious evolution of nitrous gas, and a higher 
temperature decomposes this nitrate, expelling its nitric acid and 
leaving a red oxide or peroxide. Owing perhaps to the reten- 
tion of some acid this article has never, except by some Ger- 
mans, been employed internally, being regarded a poisonous 
agent. As an eschar otic it is well known even to non-profes- 
sional persons, who employ the fine powder and the ointment, as 
best suits them, to take doivn proud flesh ; that is, to remove 
profuse granulations on ulcerated parts. A drachm of the 
powder rubbed with an ounce of lard or cerate will give a pretty 
efficient ointment of red precipitate. 

The precipitate per se is made by long exposure of mercury 
to heat and air. A matras with a tube two or three feet long is 
employed for this purpose. The mercury having been placed in 
the vessel, is submitted to a furnace heat, in a sand-bath, equal to 
600° F., for about two weeks. The tube being all the while 
open allows the vapors of the mercury to be constantly acted on 
by the oxygen of the air, and the comparative coldness of the 
upper extremity insures condensation and falling to the bottom 
during the entire process. Thus every particle of mercury is 
subjected to chemical change, and the whole mass assumes a brown- 
ish-red color. Reduction of this to fine powder by due tritura- 
tion fits it for use. 

This precipitate per se was a favorite medicine with John 
Hunter, who believed it better suited to syphilis than any other 
mercurial. He thought he could effect ptyalism with it more 
speedily than by the common mercurials ; and then the dose was 
very small. For an adult, a sixteenth of a grain is a full dose, 
to be repeated every night, or twice a day, according to the 
urgency of the case. It should be borne in mind that patients 
who are taking this medicine or blue mass should not be put on 
the use of nitric acid at the same time. This acid is held by 
some to be a powerful anti-syphilitic medicine, but it is wholly 
incompatible with the mercurials. 

The chlorides of mercury next claim our notice, and will 
occupy a large space. These, like the oxides, iodides, sulphurets, 
&c. &c, are two in number, the equivalent of mercury being al- 
ways two hundred. The one chloride is called profo-chloride, or 
simply chloride ; the other is designated as hi, or cleuto, or per 
chloride, and this diversity grows out of the fact that one con- 
tains twice as much chlorine as the other. (200 mere. 36 chl. 
= 236; 200 mere. 72 chl. = 272.) 

And first, of the simple chloride, or proto-chloride. This is 
the well-known Calomel, or suhmuriate, or mild muriate, or 
sweet muriate, or sweet mercury, or panacea of mercury, as it 
has been called by different writers. The literal import of 



498 CALOMEL. 

calomel is fair, Hack, and was based, as some think, on the 
change of color in the process of manufacture. Others supposed 
the word was intended to convey the idea of a good or fair re- 
medy for Hack bile. These are matters of conjecture, however, 
and do not in any sense affect the merits of the article. 

As a thing of mere expediency, not to say safety, I hold the 
word calomel to be preferable in our written prescriptions to any 
other term ; and the same remark is of equal force touching cor- 
rosive sublimate. By these common names all persons, boys or 
men, engaged in dispensing medicines, know the one and the 
other. But all do not comprehend the more correct technicals, 
which are oftener employed to display the imaginary knowledge 
of the doctor than because they are really to be preferred. 
Fewer blunders would occur if we invariably used the old terms. 
To illustrate the importance of discrimination between these two 
leading mercurials, we need only cite the fact that an apothecary 
and his pupil were fined severely in France for dealing out cor- 
rosive sublimate in place of calomel, and so killing three children. 
The pupil was imprisoned a month, and both were fined two 
thousand francs for the benefit of the parents. 

Calomel has been generally prepared from corrosive sublimate, 
though it can also be made from the sulphate or nitrate of mer- 
cury. If the first be selected, each equivalent of the sublimate 
must be thoroughly rubbed with one equivalent of fluid mercury. 
The trituration should not only obliterate all the globules, but it 
should give to- the mass a blackish or ash-gray color. The mix- 
ture thus made is then sublimed in a proper vessel by means of 
a suitable degree of heat. The calomel is collected on the upper 
part of the vessel in form of a cake. In the process the fluid 
mercury robs the corrosive sublimate of one equivalent of chlo- 
rine, and as a consequence the whole is reduced to calomel. If 
there be carelessness in weighing, or mixing, or in any part of 
the process, it may happen that there will be a slight excess of 
corrosive sublimate, and then the product will be vitiated more 
or less. This may serve to explain the gripings and spasmodic 
pains that almost always follow the exhibition of calomel as com- 
plained of by medical men. It is well for such persons to re- 
member that the difficulty may be obviated by washing their 
calomel several times with boiling water, which will dissolve all 
the corrosive sublimate, though it cannot take up a grain of 
calomel. To be certain that corrosive sublimate is present, let 
the collected waters be tested by adding to an ounce or two a 
little lime-water. This will give a yellow tinge instantly if cor- 
rosive sublimate be in solution. If calomel were dropped into 
lime-water the color would be an ash-gray or almost black, and 
you would have the black mercurial wash, formerly applied to 



USES OF CALOMEL. 499 

old and indolent ulcers. The yellow solution is the aqua pha- 
gedenic^ employed for a similar purpose. 

Howard's calomel, hydro-sublimed calomel, and steam calomel 
are terms given to calomel made by passing the sublimed mercu- 
rial vapors into a vessel into which steam is constantly jetting. 
The powder is thus made much more impalpable, and every trace 
of corrosive sublimate is dissolved by the hot water. It is es- 
teemed the purest kind of calomel. 

When calomel is made from the nitrate or sulphate of mercury 
it is done by precipitation and double decomposition, muriate of 
soda or chloride of sodium being employed for the purpose. It 
is essential in all these cases that the oxide of the salt of mer- 
cury be in a state of protoxide ; if it were a peroxide, corrosive 
sublimate and not calomel would be the product. 

In noticing the uses of calomel in practice I shall speak of it 
as an antiphlogistic or anti-inflammatory and reparatory remedy ; 
as a cathartic, an anti-cathartic, and anti-emetic ; as a sialagogue, 
an alterative, and finally as a poison. 

The first exhibition of calomel as an antiphlogistic or anti- 
inflammatory medicine was in America, in 1736, and by Dr. 
Douglass, of Boston, as may be seen by reference to the Edin- 
burgh Medical and Surgical Journal for Oct. 1842. The testi- 
mony being from a foreign source is the more conclusive. It 
has been employed a long while in this country in the manage- 
ment of pneumonia; sometimes alone, but oftener with ipecacu- 
anha or tartar emetic. I have succeeded most happily in pneu- 
monic inflammation with blisters to the chest and the internal use 
of calomel and ipecacuanha, two grains of the former and three of 
the latter being given every three hours. I have not known it 
to excite salivation in those cases, and suppose the force of the 
medicine was spent on existing inflammation. 

Within a few years past calomel and blue mass have been 
employed in the treatment of rheumatic and heart disease, partly 
on account of its anti-inflammatory and partly for its reparatory 
action. Its known repulsion to fibrin has given it the name of 
anti-fibrinous and anti-plastic ; and this power is displayed not 
only in preventing and arresting inflammation, but also in re- 
moving lymph deposits and restoring organs to their original 
condition. These effects are manifest in endocarditis and peri- 
carditis, and hence the value of the mercurial practice. Dr. 
Latham, in his work on diseases of the heart, has shown conclu- 
sively the importance of mercurials in inflammation, and its re- 
sults or effects. It is well ascertained that calomel and blue 
mass are best suited to constitutions free from any special taint 
or diathesis, and wholly unfit for those who give any indications 
of scofulous disease. 



500 USES OF CALOMEL. 

The anti-inflammatory and reparatory action are incompatible 
with the cathartic action. The latter, if at all considerable, 
prevents entirely the proper effects of the remedy in respect of 
inflammation. Nor is it necessary or even proper to salivate 
profusely, nor to do more than barely secure a constitutional 
impression, which can be gained by small doses exhibited for a 
short period. 

We are not able to decide whether calomel acted as an anti- 
phlogistic or anti-inflammatory remedy, when Dr. James Glark 
gave it so successfully in yellow fever. His own words are — 
"When I was called on the first day I seldom lost a patient." 
He says he gave of calomel and jalap each ten grains, as a 
cathartic, repeated every three hours. If the medicine acted 
soon or much as a cathartic, it could not work by its anti-inflam- 
matory power as obviously as if it did not purge. The fact, 
however, is valuable, and is recorded in Medical Facts, vols. vii. 
and viii., a very old work, published before Dr. Rush was so suc- 
cessful with the same remedies. 

The cathartic action of calomel is doubtless a part of its anti- 
phlogistic operation, and it has been employed, for its effects on 
the alimentary canal, in all parts of the world. The ten and ten 
of Rush, viz., ten grains of calomel and ten of jalap, excited a 
good deal of apprehension in Philadelphia, in 1793; yet Dr. 
Friend tells us, in his Ummenalogia, written many years before, 
that he gave to girls of fifteen, laboring under retention of the 
menses, fifteen grains of calomel with five of scammony for a 
cathartic dose. In very many parts of this country, thirty, 
forty, fifty, sixty grains have been regarded as a fair dose to act 
on the bowels. Teaspoonful and even tablespoon doses have 
been given sometimes as a cathartic, and sometimes for no very 
definite purpose. 

When I removed to Cincinnati, in 1831, and became an attend- 
ing physician of the Ohio Hospital, I was informed that I would 
be obliged to enlarge my Philadelphia doses of calomel. But 
the time never came when I found it necessary to do so ; and 
even in Kentucky, where the mammoth powders had been 
fashionable, I rarely exceeded my old close of ten or twelve 
grains. It was sufficient. 

I said that it was not quite certain for what end the tablespoon 
doses were given, but it is probable that some administered calo- 
mel thus as an anti-cathartic. That this was true during the 
prevalence of epidemic cholera in Lexington, in 1833, would 
seem to be probable. And here it is well to name the vast 
change in that city touching the use of calomel in the same dis- 
ease, in the summer of 1849. The most successful practitioners 
rarely gave more than six or ten grains of calomel, with one of 



CALOMEL IX CHOLERA. 501 

opium. The results were far better from six-grain doses than 
from those of four hundred and eighty grains, which were actually 
exhibited in 1833. 

In my published lecture on Asiatic cholera it is stated that 
" Dr. Scudder, who has been a missionary in India for about thirty 
years, rarely gave more than ten grains of calomel at a dose. 
Now and then fifteen grains were given with from one to three 
of opium, and this kind of dose was very successful." The state- 
ments of other gentlemen residing in that country, where the 
disease is endemic, is to the same point. And whether it be given 
as a cathartic or as an anti-cathartic, or to correct the hepatic se- 
cretion, the facts are important. We know certainly that small 
doses will meet the difficulty better than very large ones. 

A missionary writing from Bankok, in India, June 29, 1849, 
where cholera destroyed twenty thousand persons in twelve days, 
states that the most successful practice was twenty grains of 
calomel and eight of opium, administered every hour, and in 
some instances more frequently. 

In an excellent paper by Dr. Ayre, of Hull, in England, it is 
most confidently declared, as the result of large experience in 
the treatment of Asiatic cholera, that no remedy was so frequently 
successful as very small doses of calomel. He gave two grains 
every fifteen or twenty or thirty minutes, and when two or three 
hundred grains had been reached there was only a gentle 
ptyalism. He rarely gave an opiate further than a few drops 
of laudanum to secure the retention of the calomel. This is the 
same gentleman who long ago urged fractional doses of calomel 
in cholera infantum. 

Mr. Bishop confirms the practice of Dr. Ayre, and gives the 
details of several cases. He gave sometimes a grain of calomel 
every five minutes, and two drops of laudanum every hour, with 
occasional effervescing draughts. In some cases a grain of calo- 
mel was given every fifteen minutes, and effervescing mixtures 
every hour, with ten drops of laudanum in each dose. The 
vomiting and purging gave way as if by a charm. — London 
Lancet, January, 1850. 

In Roger's Reports on Asiatic Cholera in the Madras Army, • 
published in London in 1848, it is stated that large doses of 
calomel were generally laid aside, and small ones employed, by 
most of the Indian practitioners. It is also said that a mixture 
of four grains of calomel, six of sulphate of quinine, and two of 
opium, taken in a glass of brandy at the onset of attack, was 
usually successful. 

In the London Lancet for June, 1850, we find a paper by 
Mr. Cox, surgeon of Swansea, in which is a statistical table of 
cholera practice that claims- a passing notice. The large-dose 



502 ANTI-EMETIC USE OF CALOMEL. 

calomel practice and the minute doses of Ayre are put in con- 
trast, not omitting, however, the facts touching the stimulant 
plan of treatment. It is proper to say that the large doses of 
calomel here alluded to are ten grains, and rarely exceed twelve 
or fifteen. The results were as follows : — 

Patients. Deaths. 

Calomel in large doses .... 10 . . 1 
Ayre's small doses, modified ^| 

by ice, sulphuric acid, and > . . 54 13 

sponging with nitric acid J 

Stimulants and opium . . . . 17 . . .12 

Stimulants alone .... 5 3 

Tartar emetic 4 . 3 

Many southern practitioners formerly contended for large 
doses of calomel on the ground of the severity of the diseases 
there, — as, for instance, 'the southern congestive fevers. But 
this objection is now fully met by the well-known fact that many 
of the objectors have laid calomel aside, to a good extent at least, 
and have substituted sulphate of quinine, which is now their 
grand heroic medicine. Dr. Monette, the author of a valuable 
book on the history of the far South, published his views on this 
point in the New Orleans Medical and Surgical Journal for 
October, 1844 ; and avers that the only case of fever he lost in 
a given season was a man to whom a pupil gave a dose of calomel 
without his knowledge. He cures the fevers there without calo- 
mel, and others do the same thing, alleging that bilious evacua- 
tions can be secured independently of the action of that drug. 

Given expressly as a cathartic, calomel has often been highly 
injurious. This is especially true of remitting bilious fever in 
the South and West, where practitioners look for intermission 
instead of remission, and will not give sulphate of quinine, 
because the time has not come, because the tongue is not right 
and the bowels are not right. Under this delusion, they repeat 
their cathartic doses of calomel, rhubarb, aloes, scammony, and 
the like, even at the end of the first week and into the second. 

This repetitious depletion and irritation not only exhausts and 
prostrates the whole system, but in a special manner irritates the 
•mucous membrane of the bowels, establishes lesions there, and 
secures all the fatal concomitants of typhoid fever. And, after 
lingering for weeks, death is sure to take place, unless the powers 
of a vigorous constitution be able to offer effectual resistance. 

The same unwise use of calomel has been seen also in dys- 
entery, where, in place of relieving, it has displayed the effects 
of a positive irritant and thus augmented the mischiefs of the 
case. 

The anti-cathartic and anti-emetic action of calomel are dis- 
played in cholera infantum, infantile diarrhoea, and in the gas- 



ANTI-EMETIC USE OF CALOMEL. 503 

trie irritability so often seen in bilious fevers. The efficacy of 
the medicine in the first-named disease in very small doses has 
been displayed times without number in all large cities. In the 
late Dr. Edward Miller's essay, in Eberle On the Diseases of 
Children, in Bell's Notes to Underwood on Children, in Forbes 
and Connolly's Medical Revieiv, vol. vii., in the Medico- Chirur- 
gical Reviciv for 1839, in Professor Henderson's paper in the 
American Journal of Medical Sciences for 1841, and in many 
other volumes, the paramount value of minute doses of calomel 
in cholera infantum is clearly made out. I have been so long in 
the practice of treating the disease in children of twelve or fif- 
teen months old with the twelfth of a grain four, six, or ten 
times a day, and with such constant success, that I cannot but 
commend to the profession what I regard as the best kind of 
practice in that very fatal disease of children. 

The small size of the dose makes it easy of administration. 
The finger moistened takes up the little powder readily and 
lodges it far back on the child's tongue. The breast milk or a 
little water will speedily wash it into the stomach. I have known 
high irritability of the stomach, as well as of the bowels, checked 
by two or three powders. When that is the result, longer inter- 
vals between the doses will be proper; and the stools being 
greatly reduced in quantity and altered in color, once or twice 
a day will suffice for a day or two, after which the powders may 
be discontinued. 

I generally combine the calomel with gum Arabic, and occa- 
sionally with prepared chalk ; but I have tried the calomel alone 
with great success. I never had the misfortune to see anything 
like a sore mouth as the consequence of this practice, in my own 
experience. 

It will occur to all readers that infantile diarrhoea can be 
arrested on the same principle and by the same treatment ; and 
those who have never tried the remedy under such a state of 
things will find much satisfaction in putting it to the test. 

I am aware that some theoretical practitioners have objected 
that very small doses always irritate and that large doses are 
safer and better. But in an old work before quoted, viz., Medi- 
cal Facts, it is expressly stated that two-grain doses of calomel, 
given every two hours, proved very efficacious in allaying the 
high gastric irritation of bilious remitting fevers of adults. The 
very small-dose calomel practice may be regarded, therefore, as 
being well suited to irritable states of the stomach and bowels 
as they occur in the diseases before named. 

In Yeates's and McLean's Science of Life an able attempt is 
made to show that calomel is not necessarily a cathartic at all. 
They say you may give calomel for any length of time, at regu- 



504 CALOMEL A STIMULANT. 

lar intervals, gradually increasing the close, and get no stool. 
They affirm that the medicine acts only as a stimulant, and that 
if you suspend this stimulation by omitting the dose, the bowels 
then unload themselves, simply because the stimulant has been 
withheld. To what extent this doctrine may be true I am not 
prepared to say, though I do believe that the action of calomel 
on the stomach and bowels is purely relative, and depends en- 
tirely on the condition of the mucous membrane. If there be 
subacute inflammation, it may act as a counter-irritant, and so 
prove ultimately sedative ; or if there be mere irritation, it may 
operate simply to allay that irritation, and even then it would 
show something like a sedative property. 

Touching the successful action of large doses of calomel, as 
from thirty to sixty grains, in typhoid or typhus fever, especially 
in connection with cold bathing, I am rather at a loss for a 
therapeutic solution. A writer in the London Lancet for 1843 
speaks very positively of the usefulness of the practice. 

Dr. Schonlein, Professor of Clinical Medicine at Berlin, re- 
ports decided success in the use of calomel in the treatment of 
typhoid fever, carried so far as to induce slight ptyalism. He 
found it to check the diarrhoea very promptly. (See London 
Lancet, June, 1850.) 

To ivork off a full dose of calomel is sometimes an important 
matter, and a thing that must be done seasonably if we would 
save the patient from a sore mouth. To accomplish this end an 
injection will sometimes be quite adequate. The infusion of senna 
alone, or, still better, with the addition of Epsom salt, will almost 
always answer the end : a wineglassful should be given to an 
adult every two hours. Some, who are not easily salivated by 
calomel pills given for the purpose, may have their gums touched 
by a non-cathartic dose of the same medicine, or a dose large 
enough to purge ordinarily, but prevented from doing so by some 
unforeseen circumstance. Hence the need of ivorking off such 
a dose, to prevent the undesirable consequence. 

To make a dose of calomel act quite promptly we may add, 
besides an equal portion of jalap, a grain of tartar emetic or 
three to five grains of ipecacuanha. The emetic addition, while 
it will not nauseate, will exert such a relaxing influence as to 
accelerate the purgation by several hours in some instances. 

Touching the quality of stools induced by calomel there can 
be no unvarying rule. As hinted before, the change is generally 
from a light to a dark color, and sometimes they may be almost 
black. But the smallest as well as large doses will thus alter 
the stools, and occasionally they will not give rise to any very 
marked changes. Hence the folly of waiting in bilious fevers, 



CALOMEL A SIALAGOGUE. 505 

after the third day, in order to get a certain kind of stools by 
calomel before you give the sulphate of quinine. There may be 
something in the bowels, retained for weeks, whose presence may 
control the action of calomel on the color very materially. And 
if the cathartic of calomel, and other purgatives added, be repeated 
after the third or fourth day in bilious remittents, the whole mu- 
cous coat of the bowels suffers from excessive irritation, and the 
consequences are often fatal. 

The sialagogue or salivant action of calomel is not often de- 
sired by physicians at the present day. If they can be assured 
of a mercurial breath, some tenderness of the gums, with a cop- 
pery taste in the mouth, they feel assured that such a ptyalism 
is secured as may be beneficial, and they withhold the mercurial 
medicine, or reduce its dose and abate the frequency of repeti- 
tion. This is wise. It secures not only a constitutional impres- 
sion, but is kept within due bounds ; it makes the alterative effect 
equally certain, and this can be continued for a great length of 
time by renewing the dose once in two or three days. 

This moderate sialagogue or alterative use of calomel is well 
adapted to many chronic diseases, and must be continued for 
weeks or months. 

In former times a much bolder sialagogue use of mercury ob- 
tained, as we learn from the seventh volume of Haller's Disser- 
tations, which contains an interesting paper on the use of calomel 
in various diseases, by Michael Alberti, in which he presents a 
learned history of this medicine, from the Arabian physicians 
down to Paracelsus, and thence to 1745. It will be seen that 
one physician gave doses of five scruples, also of seventy-two 
grains, which affected the mouth for a fortnight. Another phy- 
sician gave his patient fifteen, then twenty, then thirty, and then 
sixty grains, which latter dose was continued till ptyalism fol- 
lowed. (See Medico- Chirurgieal Review, July, 1836.) 

In mercurial salivation the mercury may be detected in the 
salivary secretion, both by the galvanic test and by dry distilla- 
tion of the residue of the saliva. — Lehmann. 

The mercurial pulse and fever do not usually attend the use 
of mercury, excepting in those cases in which its specific effects 
are desired in a short space of time. The calomel or other medi- 
cine is pushed with vigor to the extreme point of supposed safety, 
and, as a consequence, the arterial system is shocked and mercu- 
rial fever ensues. A much safer plan is to attempt to secure 
the constitutional impression by moderate doses, aided by nitrate 
of potash and tartar emetic. Such was the plan of the late Dr. 
Rush, and it proved signally successful. His prescription was as 
follows : — 

33 



506 EXTERNAL USES OF CALOMEL. 

R.— Nit. pot. gi; 

Cal. twelve grains ; 
Tart. emet. one grain. 

Mix well, and divide into twelve powders, one to be given every two hours in 
a tablespoonful of water. 

The nitre and tartar emetic reduce arterial excitement, and 
thus prepare for the action of the calomel. The mercurial pulse 
and fever do not attend the use of these antimonial, mercurial 
powders ; or, if present, they are very faintly developed. 

Dr. Fleming has reported, in an English monthly journal, the 
high success of calomel in doses as small as the twenty-fourth 
part of a grain for the purpose of inducing ptyalism. The ad- 
vantages are the speedy action and easy control of the remedy. 
The dose above named was given every three hours, and ptyalism 
ensued at the end of thirty-six or forty-eight hours. The effect 
was milder than by the common practice, and the bowels were 
not disturbed. 

The modes of giving calomel are not numerous. Its tasteless 
quality renders it more agreeable to children than many other 
medicines, and this, with its small bulk, gives it great popularity 
as an infantile medicine. We have pointed out the manner of ex- 
hibiting it in cholera infantum, and the same plan applies to all 
young children. When deemed advisable for the insane, it can 
be placed on bread and then covered with butter. The pill form 
answers very well for those who do not object to pills. Its great 
weight and small bulk adapt it well for this method. 

Two or three external applications of calomel call for notice. 
Dusted on the external organs of generation it often relieves dis- 
tressing pruritus very speedily. The effect will depend some- 
what on the state of the stomach and bowels. For want of due 
attention to this point, the external application often fails. The 
calomel should be placed in a fine gauze bag, and applied morn- 
ing and night. The same plan is often successfully resorted to 
for the relief of excoriation or chafing behind the ears and in 
the groins. Tinea capitis is sometimes much relieved by an 
ointment of calomel applied to the head, after removal of the 
scabs by a soft poultice. Here, too, it is highly important to 
correct the state of the digestive organs. A drachm of calomel, 
rubbed with an ounce of lard or cerate, fits it for the purpose 
named. 

M. Tournie has proposed the use of calomel ointment and a 
powder of camphor and starch for the relief of prurigo of the 
genital organs, anal region, and axilla. These parts sometimes 
are covered with scabs, and then tepid baths and emollient ap- 
plications must be used first. These being removed, rub the 
calomel ointment in twice a day, (one or two drachms of calomel 



EXTERNAL USES OF CALOMEL. 507 

to an ounce of axunge,) and after each application dust over the 
parts the mixture of starch and camphor. Four parts of starch 
to one of camphor constitute the powder. — London Lancet, De- 
cember, 1851. 

An ointment is in constant use at St. Mark's Hospital, for 
small fissures about the arms, consisting of five grains of calomel 
to one drachm of lard, or elder-flower ointment, which is said to 
be preferable. The parts are to be well cleansed with warm 
water, and then the ointment is to be smeared gently over the 
surface. No dressing whatever is permitted to be worn. — Medi- 
cal Times and Gazette, Feb. 28, 1857. 

The purulent ophthalmia of children and gonorrhoeal ophthal- 
mia of adults are frequently cured by the application of calomel. 
In the former the application is made with a fine hair pencil 
charged with the finest calomel, brought close to the open eye 
and struck so as to dust the powder over the whole external 
organ. (See Edinburgh Medical and Surgical Journal, Janu- 
ary, 1844.) Dupuytren treated gonorrhoeal ophthalmia by blow- 
ing English calomel through a quill so as to lodge it on the eye. 
In this way the calomel is brought in contact with every inflamed 
spot. Parker, in his Exploring Tour beyond the Rocky Moun- 
tains, speaks of success in the same way in the ophthalmia that 
is so prevalent among the Indians. 

There are two prescriptions containing calomel that I deem 
of sufficient value to introduce here. These are Rush's pills 
and Belleville's cerate. The first is a very good cathartic, and 
often useful for the correction of the digestive organs. It is 
made thus : — 

Take of calomel, 

Powder of aloes, each two drachms ; 

Powder of gamboge, half a drachm ; 

Oil of mint, five drops ; 

Water enough to make the whole into sixty pills. 

The dose is from two to four at bedtime. They seldom disturb 
the bowels before the following morning, and then operate plea- 
santly. 

Belleville's cerate is as follows : — 

Take of acetate of lead, an ounce ; 

Red precipitate, half an ounce ; 
Calomel, two ounces ; 
White wax, four ounces ; 
Sweet oil, six ounces. 

Melt the two last and add the others in fine powder, and mix 
the whole intimately. The cerate has been long applied with 
great advantage for the cure of tinea capitis and other cutaneous 



508 CALOMEL A POISON. 

It is proper to say that calomel and sal ammoniac are decidedly 
incompatible, and that on account of the hydrochloric acid of 
the latter. The mixture, accidentally or intentionally made, 
gives rise to corrosive sublimate. 

A few words on the poisonous action of calomel will be proper 
at the close of this history of its uses. In a paper which I pub- 
lished in the New Orleans Journal, No. 1, it was shown that this 
article is often a source of poisoning. I may say here that it is 
not possible to name a definite quantity that will always or gene- 
rally develop poisonous results. The same quantity may act 
very differently on the same person at different times. Hundreds 
of persons were poisoned during the prevalence of Asiatic cholera 
in 1833, '34, and '35, in the West, by mammoth doses of calo- 
mel. I had proof enough of this in Palmyra, Mo., on my arri- 
val there in July, 1835. Even in other diseases of far less 
severity this medicine has been administered with decidedly 
ruinous or poisonous consequences. 

In the American Journal of Medical Sciences, vol. ii. p. 42, 
Dr. Heustis, then of Cahawba, Alabama, thus wrote: — " The 
horrid spectacles frequently to be seen as the consequences of 
the mercurial treatment are shocking to humanity and disgrace- 
ful to the profession. Even were mercury the only alternative, 
that life is dearly purchased which is bought at the sacrifice of 
everything that renders life desirable, the constitution broken and 
destroyed, the person maimed and disfigured, so that it is scarcely 
recognized by the unfortunate sufferer himself, who is an object 
of pity and horror to his friends. Deprived of their teeth, 
perhaps of their jaws, we sometimes see those pitiable objects 
with distorted features, the cheeks and palate partly destroyed 
by mortification, and the remaining portion cicatrized into an 
unsightly knot, with the mouth twisted from its natural position, 
drawn obliquely to the ear, and the lips and cheeks consolidated 
with the gums." 

The same writer, when residing at Mobile, furnished another 
paper for the same journal, vol. xix., in which he says, " I have 
known an artificial disease produced and kept up by the daily 
exhibition of calomel ; and because a flow of saliva was not ex- 
cited it was concluded that the medicine had not exerted its 
specific effect, or not been given in sufficient quantity. It was 
therefore pushed further, and sloughing and mortification of the 
gums, cheeks, and fauces, and death itself following in the train." 

The distinguished surgeon Liston avowed his belief that no 
man ever lost the bones of his head or face by syphilis alone, 
and that the result was caused chiefly by mercury. 

We are furnished with additional evidence of the deleterious 
action of calomel by Mr. Annesley, in Sketches of the Diseases 



CALOMEL A POISON. 509 

of India. He performed a series of experiments for the express 
purpose of ascertaining the true operation of calomel, "and 
these experiments presented uniform results, viz., that while the 
stomach and duodenum of dogs that had taken large doses of 
this preparation were much paler and less vascular than in ordi- 
nary circumstances, the colon and rectum, from the caecum to 
the verge of the anus, were most acutely inflamed, thereby ex- 
plaining the results of clinical observation, namely, that although 
large doses of calomel calm those symptoms usually caused by 
increased vascular action, or inflammation of the mucous sur- 
face of the stomach and duodenum, they lower the vital energy 
of these important organs, and occasion tenesmus, griping pains 
in the course of the colon, mucous or bloody stools, hemorrhoids ; 
and if persisted in, many more of the symptoms of dysentery, or 
even structural change of the colon and rectum. I am confident 
that dysentery becomes chronic ; that an occasional indigestion 
lapses into a constant dyspepsia ; and that habitual constipation 
often passes into strictures of the rectum, and hemorrhoids into 
fistulae, from the frequent exhibition of large doses of this medi- 
cine. Ingenuity cannot possibly devise a more successful method 
of converting a healthy person into a confirmed invalid, of de- 
stroying many of the comforts of existence, and of occasioning 
hypochondriasis and melancholy than the practice of prescribing 
large doses of calomel on every trifling occasion, or when the 
bowels require gentle assistance ; or because the patient erro- 
neously supposes himself to be bilious, or is told so by those who 
should know better. The unfortunate word ' bilious is the scape- 
goat of the ignorant." 

Does the infinitesimal practice ever induce salivation ? If so, 
the disciples of Hahnemann had as well be silent about our calo- 
mel practice. I know a very respectable gentleman, a devotee to 
the invisible doses, one of whose children happened to get his 
hand into the little box of physic, and was so charmed with the 
diminutive white pills that he emptied the contents of the vial 
into his stomach. He swallowed, probably, ten or a dozen of the 
harmless little things, but in a few hours after, the favorite 
homoeopathic doctor was sent for, when lo ! the gentleman de- 
cided the case to be mercurial salivation. The parents knew 
that the vial was labelled mercurius, but never dreamt that calo- 
mel, that hideous article, was there. 

The facts proving the poisonous action of calomel are almost 
innumerable, but enough has been said on that point. 

Much diversity of opinion has obtained touching the poisonous 
action of calomel on children who are seized with gangrene of 
the mouth and face, sometimes called cancrum oris. A case has 
been reported in the Boston Medical and Surgical Journal, 



510 CORROSIVE SUBLIMATE. 

July, 1845, of a child ten years old who died of extensive mor- 
tification, induced by twenty-grain doses of calomel. A case is 
also reported in the Western Lancet for August, 1845, and 
many others could be referred to. The facts seem to show that 
under certain circumstances calomel may develop the poisonous 
phenomena above named. But it is equally certain that the dis- 
ease in question may be set up wholly apart from the action or 
even the use of calomel. Thus it is sometimes seen in hospitals 
for children in the nature of charity establishments. The bad 
ventilation, want of cleanliness, &c. may give rise to a single 
case, and presently several will be found, until at length the dis- 
ease assumes the epidemic form. The exposure of all to the 
same deteriorating agency creates a common predisposition, and 
hence the general prevalence. Thus it was many years ago in 
the Children's Asylum of Philadelphia. This form of gangren- 
ous ulceration is best managed by the free use of chlorate of 
potash in watery solution, so as to give a child five years old 
from one to three drachms in twelve hours. It is supposed by 
some to act by oxygenating the blood. 

I am inclined to think that the same medicine will prove very 
useful in cases of poisoning by mercury, in the shape of profuse 
salivation and some ulceration of the mouth. When the patient 
is greatly enfeebled, a strong acidulated solution of the sulphate 
of quinine should be liberally administered. 

As a means for arresting profuse mercurial salivation, tincture 
of iodine may be painted on the mucous lining of the mouth and 
on the gums. A strong infusion of green tea, a solution of tan- 
nic acid, or infusion of galls may be employed as a mouth-wash. 
Velpeau applied hydrochloric acid to the gums with a hair pencil, 
and promptly arrested the flow. 

Corrosive sublimate next claims attention. It is the hi, or 
deuto, or per chloride, and was formerly known as oxymuriate, 
Jiyperoxy muriate, &c. It is made by subliming a mixture of the 
sulphate of peroxide of mercury and chloride of sodium or mu- 
riate of soda. The resulting compounds are bichloride of mer- 
cury and sulphate of soda. Corrosive sublimate is soluble in hot 
water, and very slightly so in cold water ; while calomel is not 
soluble in either. Both compounds are white, but calomel shows 
occasionally a tinge of yellow or blue not seen in corrosive sub- 
limate. The taste of corrosive sublimate is very acrid, while 
calomel is tasteless. The specific gravity of the latter is 7.2, 
that of the former 5.2. Both are slightly altered by long ex- 
posure to light, and hence should be kept in opake or covered 
bottles. A solution of corrosive sublimate in water is changed 
to yellow by the addition of lime-water ; the same addition to 
calomel gives an ash-gray or nearly black color. The former 



MERCURIAL CIGARS. 511 

constituted the aqua phagedenica, and the latter the black ivash, 
of the old authors. Such are the points of dissimilarity which 
every medical man should remember. 

Corrosive sublimate is a term given to the article because of 
its acrid action on the mucous coat of the stomach and on other 
parts. Its energetic nature is plainly manifested by this appel- 
lation, and everybody is aware of it. The patent medicines for 
the cure of venereal diseases, and the doses of quack doctors 
very generally contain this acrid preparation. It was detected 
by Professor Hare in Sivaims panacea, although its presence in 
that popular compound was for a long time denied. Venereal 
quacks, sailor-doctors on board of steamboats on the Ohio River, 
give corrosive sublimate in whisky or gin or diluted alcohol, be- 
cause the dose is more agreeable to their patients. In very 
minute portions, the German physicians have long been partial 
to it as an alterative in the treatment of secondary syphilis. 
Ten grains rubbed intimately with mucilage of gum Arabic, and 
divided into one hundred and twenty pills, one of which to be 
taken morning and evening, constitutes the mercurial treatment. 
Each pill contains precisely a twelfth of a grain, which may be 
regarded as the proper adult dose. Even that quantity has 
proved a decided irritant, calling for the modifying agency of an 
opiate. Sometimes the Germans have combined it with blue mass, 
two grains of the latter being rubbed with a twelfth of a grain of 
the former. This combination, as we are assured, will more speed- 
ily set up a slight ptyalism than any other mercurial prescription. 
Another formula to which the same people are very partial, is as 
follows : — 

Take of corrosive sublimate, one grain ; 

Sal ammoniac, in fine powder, five grains ; 

Water, an ounce. 
Mix. 

Of the solution so made the dose for an adult is a fluidrachm 
added to an ounce of cinnamon-water or ginger tea, and repeated 
twice a day. If gastric pains ensue, add to each dose an eighth 
of a grain of sulphate of morphia. 

Mercurial cigars have been made and employed as a means of 
introducing very minute portions of corrosive sublimate into the 
system. The proposition was first made to the French Academy 
of Medicine, as we learn from the London Lancet for May, 
1843. The plan was to impregnate tobacco leaf with a weak 
solution of corrosive sublimate, having previously washed the 
leaf carefully in hot water to free it of its nicotine. The leaf 
was then rolled into the form of cigars and smoked in the usual way. 

A writer in the Edinburgh Medical and Surgical Journal, 
vol. xv., gives a new mode of effecting ptyalism by corrosive 



512 EXTERNAL USES OE CORROSIVE SUBLIMATE. 

sublimate, which I regard as wholly improper, while it is cer- 
tainly uncalled for. He directs the skin to be slightly scarified 
with a fine lancet in various spots, and to sprinkle over the sur- 
face a small quantity of very finely-powdered sublimate. It is 
stated that salivation can be induced in this way in twenty-four 
hours. I cannot imagine a case that could justify this plan, 
unless perhaps one of the terribly fatal maladies that almost 
invariably destroy life. A German physician, Dr. Wedekund, 
employs a bath of corrosive sublimate as the best expedient for 
inducing pytalism. He adds a drachm of corrosive sublimate 
to a pint of water at ninety, and employs the bath chiefly in the 
management of cutaneous affections. 

The external uses of corrosive sublimate have been quite nu- 
merous, sometimes salutary and often injurious. I have em- 
ployed a solution of three grains in six ounces of rose-water 
very efficaciously, in the eruption resulting from the poison of 
sumach, taking care at the same time to act freely on the bowels 
with cathartic medicine. 

Old and ill-conditioned ulcers are often improved by a solu- 
tion of two grains of the sublimate in two ounces of lime-water, 
constituting in fact the aqua phagedenica. The same solution 
has been employed by a German physician in Maryland, Dr. 
Huitze, as a remedy for burns and scalds; but it cannot be a 
safe application, and we have, moreover, others that are of less 
doubtful expediency and equally salutary. 

The celebrated G-owland's lotion is a solution of corrosive 
sublimate in an emulsion of bitter almonds, in the proportion of 
a grain to the ounce. M. Bally recommends a solution of four 
grains in four ounces of water as a collyrium, to be used in acute 
and chronic ophthalmia at least ten or twelve times a day. 

I have no doubt that preparations such as have been already 
named may frequently be serviceable, and indeed my own ex- 
perience is in their favor, under suitable restrictions. Yet it is 
very certain that serious evils have followed the indiscriminate 
and injudicious application of solutions that were by no means 
concentrated. Cases have been reported (and I have known 
some of them by credible information) of the ordinary symp- 
toms of poisoning, as the consequence of washing a sore on the 
face with solution of this article. Dr. Miguel furnishes the case 
of a gentleman who long suffered from psora, and who was cured 
at last by lotions of corrosive sublimate. The disappearance of 
the skin-disease, however, was followed by severe monomania, 
which could not be controlled until high irritation of the skin 
was reproduced. The reporter adduces the fact to show the 
great danger of suppressing an old disease of the surface with- 
out, at the same time, acting smartly and for days on the 



POISON OF CORROSIVE SUBLIMATE. 513 

alimentary canal. Another case, equally striking, is given 
substantially as follows: — A robust man, aged forty, suffered 
from an eruption on both hands for the space of two years. 
He employed the lotion of corrosive sublimate and was cured, 
as he fondly hoped. But very soon a cough assailed him, at- 
tended with severe pain in the breast, and he sank in less than 
four months under tubercular consumption. These and many 
like facts serve to show the danger of corrosive sublimate as a 
wash, where there exists even a slight predisposition to disease 
of vital organs. An old cutaneous disease should never be at- 
tacked by such an agent, nor by any other, apart from repeated 
cathartic action, or the establishment of a drain in the nature 
of seton, issue, or perpetual blister, to compensate for the dis- 
charge to be arrested or the skin-disease to be cured. 

Ranking (vol. i. p. 324) has the cases of two children who 
were killed by a lotion of corrosive sublimate to the head to 
cure ringworm. All the usual poisonous symptoms occurred, 
and in one of the cases profuse salivation with sloughing of the 
gums and tongue. 

It is impossible to fix the poisonous dose of corrosive subli- 
mate, because the effect is necessarily relative. In Paris and 
Fontainbleau's Medical Jurisprudence, vol. ii., the story is told 
of a Turk who took daily a drachm of corrosive sublimate, and 
was known by the name of the corrosive sublimate-eater. On 
one occasion he visited a Jew's shop which was partly an apothe- 
cary concern, and called for a drachm of his daily luxury. No 
sooner was it handed out than swallowed, to the great consterna- 
tion of the poor salesman, who, dreading the result and his im- 
plication in the affair, instantly closed the windows, locked the 
door, and remained for the rest of the day invisible. A mere 
accident, in due season, relieved his embarrassment. 

- In such a case as the one just stated there is much to interest 
and yet to perplex us. How did the Turk acquire the power of 
endurance so as to be unhurt by sixty grains of this very poison- 
ous article? Probably it was the result of a very slow increase 
in quantity from clay to day for months ; or the stomach might 
have been rendered insensible to its ordinary impression by the 
long-repeated use of other articles, as opium, brandy, and the 
like. 

The following case of poisoning by corrosive sublimate is 
taken from the Edinburgh Medical and Surgical Journal for 
the year 1839, and is peculiarly interesting not only in regard 
to the symptoms and morbid appearances, but also because the 
poison was supposed to have been taken in mistake for a dose of 
calomel. 

On the 26th of August, 1838, a man, aged forty-seven, applied at 



516 TURPITH MINERAL. 

medico-legal investigations. It is well to recollect that it may 
be absolutely impracticable to trace it in any part of the system. 
In the Edinburgh Medical and Surgical Journal for July, 1844, 
we have a case of this kind. The man took two drachms of the 
poison and died after four days of severe suffering. All the 
ordinary appearances were disclosed by the knife, but it was not 
possible to find a trace of the poison in any part of the body, 
although the best tests were applied. 

It is easy to conceive of a case in which early and continued 
vomiting and purging would eject from the system every particle 
of any poison. But then it would not be difficult to detect it in 
the matters thrown out of the stomach or in the f cecal discharges, 
and there it should be sought. 

Various methods are in use for the detection of corrosive sub- 
limate. The best tests for it in the solid state are the action of 
an alkaline carbonate aided by heat, and that of a caustic alka- 
line solution. For the solution, the best tests are solution of 
potash, iodide of potassium, protochloride of tin, and sulphureted 
hydrogen. Galvanism has been employed to detect its presence 
in connection with gold ; the mercury of the sublimate is reduced 
to the metallic state and forms an amalgam with the gold. By 
dropping the solution of the sublimate on a piece of polished 
gold, on a sovereign or an eagle, and touching the moistened spot 
with the point of a penknife, or by applying a key so that it may 
touch simultaneously the gold « and the solution, the bichloride 
will be decomposed and a mercurial stain like silver will be left 
on the gold. 

Turpith mineral, written also turpeth and turbith, is the sul- 
phate of the peroxide of mercury, and frequently called sub- 
sulphate of mercury. It is made by pouring five or six pounds 
of boiling water on a half-ounce of bi-per sulphate of mercury, in 
a large flask or basin. The latter-named salt is formed by boil- 
ing two parts of fluid mercury in two and a half parts of sulphu- 
ric acid to dryness, the mixture being exposed to heat in a glass 
vessel over a common fire. 

The brilliant yellow salt produced in the manner named above 
was the favorite emetic of the French, and continues to be so. 
It is too little known and appreciated in this country. Dr. Hub- 
bard, of New England, has attempted to bring it favorably before 
the profession of this country, but it does not bid fair to rise very 
high in their estimation. It is an excellent emetic in doses of 
from two to five grains, and well suited to croup after general or 
local bleeding. In smaller doses, as a quarter or a half-grain, it 
is a good alterative ; and has also been employed as an errhine 
mixed with common snuff. 

In the fourth volume of Medical Facts, page 128, is a notice 



NITRATE OF MERCURY. 517 

of gutta serena cured by the use of snuff composed of thirty-five 
grains of pulv. asari and five grains of turpith mineral. A pinch 
was taken every night for three weeks. For several days the snuff 
induced bleeding from the nose. 

Ricord has employed an ointment of the turpith mineral with 
very good effect in what he calls squamous diseases of the shin, 
meaning probably a sort of herpetic affection. Thus : — 

R. — Ung. sulphur, ^i; 

Turp. min. grs. xv ; 

Pix liquid. 31. 
Mix. 

A small portion of this unguent is to be smeared over the dis- 
eased spots night and morning. (See London Lancet, July, 
1843.) 

Turpith mineral, in common with other mercurials, is capable 
of inducing fatal poisoning. A case is reported in the American 
Journal of Medical Sciences for October, 1847, of death as the 
consequence of the severe irritant action of a drachm of this salt. 
The case is a rare one. We suppose the best treatment, after 
dislodging the poison by an emetic or by' the stomach-pump, would 
be to administer freely all sorts of emollient and mucilaginous 
articles, as sweet oil, slippery elm infusion, gum Arabic water, 
and the like. 

Nitrate of mercury, as such, is not often employed medicinally. 
It is the basis of the well-known vitrin or citron ointment. The 
salt is usually prepared by dissolving an ounce of mercury in 
eleven drachms of nitric acid. This is usually accomplished 
without heat, and should be if practicable. If the action fail, 
then apply a very moderate heat to start it, and instantly with- 
draw it. The object of this case is to secure a proto-mtY&te. If 
heat were employed during the entire process, a per-mtr&te would 
probably result, or a mixture of the two. 

While the solution of the proto salt is yet hot six ounces of 
lard and four of sweet oil should be added, the whole being 
stirred frequently with a smooth ivooden spatula, and never with a 
metallic instrument. The latter would discolor and disfigure the 
product. When the mixture is quite cold, you have a pretty lemon 
or citron-colored ointment. If it be too energetic for use, it can 
readily be reduced by admixture with lard or cerate. 

A Philadelphia apothecary, the late Peter Lehman, proposed a 
formula somewhat different from the above, which may be seen 
in the Journal of Pharmacy for July, 1842. He gave it as the 
fruit of much attention to the subject, and held it in great esti- 
mation. He called it camphorated citrine ointment, says it re- 
tains its color and consistence for any reasonable length of time. 
The formula is as follows : — 



518 CITRIN OINTMENT. 

Take of unsalted fresh butter a pound, put it in an open stone 
jar and soften it so as to be able to stir it. To a part of the 
butter so prepared add four drachms of pulverized camphor, and 
mix intimately. Then dissolve two ounces of quicksilver in two 
ounces of pure nitric acid, and when dissolved stir the solution 
into the butter gradually. At first it has a whitish appearance, 
but in a short time it acquires an orange-reddish and finally a 
beautiful gold color. 

The soft citrin ointment has long been in use as an application 
to ulcers of the eyelids, and small sore spots on the tarsi, associated 
with marks of inflammatory action. A camel' s-hair pencil is the 
best instrument for making the application. In herpetic diseases 
of the skin, in crusta lactea, &c. &c, the ointment has also been 
a popular remedy. Some practitioners esteem it highly as a 
remedy for scald head. 

The watery solution of nitrate of mercury has been found a 
very useful lotion for the ulcerated sore mouth of young children. 
The spots are to be touched with it as you would apply lunar 
caustic, and the effect is very much the same. Bennet speaks 
favorably of the caustic action of the same solution, when applied 
to the os uteri laboring under ulceration, with more or less in- 
flammation and induration. 

The white precipitate of mercury was formerly much in use in 
the shape of powder and ointment. It is made by the mutual 
decomposition of corrosive sublimate, sal ammoniac, and carbo- 
nate of potash. A white precipitate falls, and hence the com- 
mon name. The technical term is the ammoniaco-chloride of 
mercury. It is a compound of two hundred and sixteen peroxide 
of mercury, and fifty-four muriate of ammonia, in two hundred 
and seventy parts. The fine powder has been employed to dust 
on excoriated parts. A drachm rubbed with an ounce of cerate 
or lard makes an ointment sometimes resorted to for cutaneous 
diseases. Many persons use it for the cure of common itch. 

J. Giles, Esq., reports a case of poisoning by white precipitate 
of mercury, in the London Lancet for September, 1857. The 
quantity swallowed was thought to be a half-drachm, at least. 

The patient was a young female, who took the dose in a cup 
of tea at half-past five P.M. She became very sick, and had 
severe gastric pains. Not before ten p.m. did the mother find 
the cup from which the girl had taken the dose, and as some of 
the white powder remained, it was examined, and proved to be 
ammoniaco-chloride of mercury, or white precipitate. The pain 
continued, followed by free purging. An emetic of sulphate of 
zinc was given, and plenty of milk. In about ten days she was 
well enough to go about her usual business. 

Acetate of mercury is the basis of a medicine that for a long 



SULPHURETS — CYANIDE. 519 

time enjoyed a large share of popular regard, and known as 
Keyser's pill. 

The sulphurets of mercury merit some attention. There are 
two sulphurets, differing in the relative quantity of sulphur and 
in color. The proto-sul^huret, called often by the name sul- 
phuret, is composed of one equivalent of sulphur and one of mer- 
cury ; the hi or c?e^o-sulphuret, containing the same quantity of 
mercury, but twice as much sulphur. The first is blacJc, and 
thence called black sulphuret; the other is red, and therefore 
known by that distinction. 

The jEthiops mineral of the old writers is the black or proto- 
sulphuret, and was once highly valued as a remedy for worms, 
and consequently called anthelmintic. I have taken it in child- 
hood in this relation, as it was a favorite with the late Dr. Samuel 
P. Griffiths, who prescribed it in my case. The dose varies 
from five to thirty grains, according to age, and is readily taken 
with any kind of syrup. 

This medicine is quickly prepared by triturating in a glass 
mortar equal weights of mercury and flowers of sulphur until 
all the globules disappear. In a few minutes a black powder is 
formed and ready for use. A distinguished French practitioner, 
Serres, administered, as he thought with success, this iEthiops in 
typhoid fever. He gave it in fifteen-grain doses, daily, and 
at the same time covered the entire abdomen with mercurial 
ointment, which remained until signs of improvement were 
visible. 

The red or efowfo-sulplraret, called also cinnabar, has seldom 
been administered internally. Dr. Pitschaft, of Germany, ex- 
hibited it to children having some tokens of scrofula, as follows : 

Take of cinnabar, a scruple ; 

Cicuta leaf, two grains ; 
Red precipitate, one grain ; 
White sugar, half a drachm. 
Rub the whole well together, and divide into twenty powders, one of which to 
be given morning and evening. 

The following ointment has been employed by Biett, in obsti- 
nate prurigo of the hands, with success : — 

R. — Cinnabar, 

Tinct. opii, aa gij ; 

Sulph. Subl. -§ss; 

Adip. suillge, ^v. 
Mix intimately. 

The bi-cyanide of mercury, called also cyanide, cyanuret, 
prussiate, &c, is not much known to the profession in America, 
though often employed in Europe with success in syphilis and 
suppression of urine. It is entitled to some notice, therefore, in 
this place. It is made by boiling eleven parts of the red oxide 



520 IODIDES OF MERCURY. 

of mercury with eight of Prussian blue in a suitable quantity of 
water. Double decomposition ensues, and the product is color- 
less, although both ingredients are of bright colors ; it is also in- 
odorous, styptic, and disagreeable to the taste. It is quite solu- 
ble in hot water, and less so in cold water. 

This medicine is given in watery solution and in the form of 
pill. Twelve to twenty-four grains dissolved in a quart of pure 
water make a mixture of which from one to four tablespoonfuls 
may be taken twice a day in a little gum-water. Pills, made by 
incorporating with conserve of roses, should contain from an 
eighth to a sixteenth of a grain. In any form it calls for great 
caution, because of its highly poisonous nature. It is not pro- 
bable the bi-cyanide will ever come into general use, nor is it 
necessary. We have safer and better articles, and it is wise to 
give them our preference. 

The iodides of mercury, or iodurets, are the proto and deuto- 
iodide, called also iodide and biniodide. These compounds have 
been ascertained to be specially adapted to syphilis engrafted on 
scrofulous constitutions, or, in other words, to scrofulus syphilis. 
It has long been known that the worst kinds of venereal cases 
were found in persons of a scrofulous habit, and that mercurials 
not only did not improve them but actually made them worse. 
The combination of iodine with mercury was found to meet the 
difficulty, and the complication alluded to most happily met by 
the new expedient. The iodine promotes the natural and salu- 
tary action of the glandular and absorbent system, while the mer- 
cury is thus allowed to display its peculiar agency in subduing 
the venereal affection. On this principle some of the most 
appalling cases of syphilis were completely cured, after having 
for a series of years resisted all ordinary mercurials and being 
actually made worse by their agency. 

The protiodide is prepared by adding one hundred parts of 
proto-nitrate of mercury to four hundred parts of pure water 
and filtering the solution, after which a strong aqueous solution 
of hydriodate of potash is added till a precipitate no longer falls. 
This must be collected on a filter, well washed with pure water, 
dried, and kept in opake bottles. It is a greenish-yellow, or 
yellowish-green powder, and is employed in form of pill and oint- 
ment. Thus : — 

Take of extract of juniper, twelve grains ; 
Protiodide of mercury, one grain ; 
Mix, and divide into eight pills. 

The dose is one pill night and morning for a few days, then laid 
aside a day or two and resumed. 

The ointment is made by rubbing twenty grains of the prot- 
iodide with an ounce and half of lard. It is applied to venereal 



MERCURIAL COMPOUNDS. 521 

ulcers and rubbed into indolent tumors, causing healthy action 
and promoting cicatrization. The following prescription is re- 
ported as having been very successful in engorgement of the 
mammary glands. The account is furnished by Pelletier. 

Take of Protioclide of mercury, six grains ; 
Acetate of morphia, eight grains ; 
Lard, an ounce ; 
Mix. 

A piece as large as an ordinary nutmeg must be gently rubbed 
on the surface night and morning. 

The red, or deutiodide, or biniodide, is made by adding a solu- 
tion of hydriodate of potash to a solution of corrosive sublimate 
in water, both solutions being pretty strong. A red precipitate 
falls to the bottom, which is to be collected on a filter and washed 
with pure water till the fluid passes tasteless. Dry the precipi- 
tate, pulverize, and keep in close bottles to guard against the 
light. This red powder is soluble in hydriodate of potash and 
mercurial salts, as well as in acid and alcohol. Pills and oint- 
ment of the deutiodide are made pretty much as those of the prot- 
iodide. The deutiodide is much more energetic than the other 
iodide, and less frequently employed. 

The iodo-hydrar gyrate of potassium is a comparatively new 
mercurial medicine, first introduced by Dr. Channing, of New 
York, in 1834. The ingredients for making it are three and a 
half grains of hydriodate of potash, four and a half grains of 
deutiodide of mercury, and one ounce of water. The hydriodate 
of potash must be dissolved in the water first, and the deutiodide 
added. Of the solution, from two to five drops may be given 
three times a day. Each dose contains from one-thirtieth to one- 
twelfth of a grain of the iodo-hydrargyrate of potassium. Dr. 
Channing regarded it as a kind of panacea. Dr. Charles C. Hil- 
dreth, of Ohio, published a good paper on it in the American 
Journal of Medical Sciences, vol. xxvi. He regards it as the 
very best combination of iodine and mercury for the purposes of 
an alterative, and as a corrector of depraved secretions of the 
mucous membrane of the stomach and bowels ; and, therefore, an 
excellent medicine in dyspepsia. 

The last mercurial medicine to be named is the liquor of the 
hydriodate of arsenic and mercury. This has been highly praised 
in cutaneous and uterine affections. It is made as follows : — Tri- 
turate 6.08 grains of the powder of metallic arsenic, 15.38 of 
mercury, and fifty grains of iodine, with one drachm of alcohol, 
until the mass is dry and of a pale red. Add eight ounces of dis- 
tilled water, and, afler a few moments' trituration, transfer the 
whole to a flask. Add a half-drachm of hydriodic acid, made by 
acidifying two grains of iodine, and boil for a few moments. 

34 



522 MERCURIAL COMPOUNDS. 

When the solution is cold, if there be any deficiency of the 
original eight ounces, add enough pure water to make it up. 
Each drachm measure of this mixture contains an eighth of a 
grain of protoxide of arsenic, a quarter-grain of protoxide of 
mercury, and four-fifths of a grain of iodine, as hydriodic acid. 
The solution has a yellow color, with a pale tinge of green. It 
has rather a styptic taste. Opiates are incompatible. The medi- 
cine may be taken in ginger tea, or tincture of ginger. Donavan 
prescribed it thus : — 

Take of liq. hydr. ars. and mere, two drachms ; 
Pure water, three and a half ounces ; 
Syrup of ginger, half an ounce. 
Mix, and divide into four doses, one of which to be taken every night. 

Each dose contains one-sixteenth of a grain of protoxide of 
arsenic, a quarter of a grain of protoxide of mercury, and two- 
fifths of a grain of iodine. The action of the medicine would 
appear to be alterative. (See American Journal of Medical 
Sciences for April, 1843.) 

To insure success in the process given above, all the ingredients 
must be perfectly pure and be thoroughly triturated together. 
Souberain calls the solution the iodo-Jtydrar gyrate of arsenic, and 
proposes to form it by boiling one part of iodide of arsenic, one 
part of biniodide of mercury, and ninety-eight parts, by weight, 
of pure water, together. By this means, he affirms, we get a 
perfect solution with far less trouble than by the method of 
Donovan. 

The solution has been successfully applied to the cure of all 
kinds of scaly cutaneous eruptions, constitutional syphilis, lupus, 
&c. Its use is sometimes external as well as internal. The 
constitutional effects of arsenic rarely attend its exhibition, but 
now and then slight ptyalism supervenes. The usual adult dose 
is from five to twenty drops two or three times daily, and is best 
given in a little water, as other vehicles would probably decom- 
pose it. The London Lancet for September, 1857, page 247, 
has an article showing the happy effects of the medicine in a very 
extensive psoriasis guttata, running into lepra. The patient, a 
lad eight years of age, was what is called a coal-ivhipper, and 
was kept on poor fare. The Fowler's solution of arsenic did no 
good whatever ; and Mr. Curling determined to try Donovan's 
solution, three drops three times a clay, aided "by alkaline baths 
every other day. The success of the remedy was soon most 
apparent, the eruption entirely disappearing and dying out. 

As mercury has been held to be indispensable in the treatment 
of syphilitic affections', the following testimony is important: — 
" On a recent visit to the syphilitic ward of the Royal Free Hos- 
pital, where a number and variety of syphilitic disease are to be 



HENBANE. 523 

met with, especially of the secondary eruptions, we find they are 
treated by the administration of stomachic and tonic remedies 
and good diet, conjoined with the following formula, viz. : Sul- 
phur, one drachm ; sulphuret of antimony and nitrate of potass., 
of each five grains ; mixed into a powder, half of which is given 
night and morning, and persevered in till the eruption disappears, 
the health is improved, and a cure established. Dr. Marsden has 
employed this mode of treatment for twenty-seven years, in thou- 
sands of cases, and he observed that not one in a hundred in- 
stances has he known to return with constitutional symptoms. 
In the primary forms of syphilis he trusts to stomachics solely, 
with good diet. This is a very interesting and highly important 
fact in the treatment of syphilis. The cases of secondary erup- 
tions under this plan of treatment, which we saw on the first of 
June, fairly spoke for themselves, as they were gradually dying 
away." — Lancet, June 27, 1857. 

We hope to find this medicine more in use in this country. 

Hydropathy. (See Water Cure.) 

Hyosciamus Niger. Henbane. Black Henbane. — A very 
ancient medicine, known to the Greeks and Arabs. The leaves 
and seeds of the plant are employed. The leaf has a peculiar 
narcotic odor and a bitter taste, which are a good deal weakened 
by drying, especially if artificial heat be employed in the process. 
In 1775, Dr. Boorde published a Breviary of Health, in which 
he advised, as a remedy for toothache, a candle made of wax and 
henbane seeds, the smoke of which was to be directed into the 
hollow tooth. The roots of henbane were formerly cut into slices 
and made into necklaces, to be worn on the necks of young chil- 
dren, to accelerate the process of dentition and to make it less 
painful. From time immemorial, poultices of the leaves have 
been in use as anodyne applications to painful tumors. 

Henbane fell into long disuse, and was revived by Dr. Stoerck, 
of Vienna ; regained its former popularity ; was again neglected, 
and then recovered a little of its lost reputation. Stoerck em- 
ployed it in a number of cases in which opium seemed to be for- 
bidden, and with happy results. He found it to allay irritation, 
obviate pain, and tranquilize the nervous system, without inducing 
constipation ; and such is its character at this time. In his day 
it was exhibited in rheumatic disease, and applied externally to 
glandular swellings and tumors regarded as cancerous. As a 
topical remedy, the leaves were preferred to the seeds ; and, 
having been well bruised, they were mixed with soft crumb of 
bread and made into poultices. In some instances a cerate 
cloth was dusted well with the fine powder of the leaves and then 
laid on the affected part. 

The extract of henbane is now in more general use than the 



524 HENBANE. 

leaves. A very efficient extract can be made by rubbing the 
fresh leaves in a glass or stone mortar, adding a very little water. 
The juice so obtained is next evaporated slowly to a due consist- 
ence. The dose is from two to six grains, gradually increased. 
I regard it as fully equal to the alcoholic extract, excepting the 
mere circumstance of the latter resisting change from the heat of 
summer best. This extract is readily made by acting on the 
leaves with alcohol, to procure a very concentrated tincture, 
which, on evaporation, gives the article in question. 

To relieve habitual costiveness, we sometimes combine the ex- 
tract with ordinary cathartics, and thus avoid griping. For this 
end, six grains may be joined to the usual cathartic dose. 

A very good combination is found in blue mass, Dover's pow- 
der, and extract of henbane, for rheumatic affections attended 
with hepatic derangement. Five grains of each may be mixed 
and divided into three pills, to be taken at bedtime. If the 
opium of the Dover's powder be disagreeable, omit it, and aug- 
ment the quantity of extract, not forgetting to add from three 
to five grains of ipecacuanha. 

In some cases of cough and pulmonary irritation not perhaps 
clearly defined, the union of henbane with cicuta will be beneficial, 
especially after depletion, if that be called for. The following 
mixture, called a pectoral, may be given in such cases : — 

Take of ext. cicuta, 

Ext. of henbane, aa five grains ; 
Powder of gum Arabic, two drachms ; 
Spirit of mindererus, 
Water, aa half an ounce ; 
Syrup of squills, two drachms. 
Mix these together for a single dose, to be taken at bedtime. 
We can also very advantageously combine tartar emetic with 
extract of henbane, a grain of the former and two scruples of 
the latter divided into ten pills. One of these should be taken 
at bedtime, and one every four hours through the day, for the 
relief of irritative cough. 

After free action of the bowels of females laboring under puer- 
peral mania, no medicine is more soothing and safe than the 
extract of henbane, in doses of from five to ten grains, with or 
without blue mass. The latter is an important addition, when it 
is known that the liver is in a very torpid state. 

In excessive doses, henbane displays all the tokens of narcotic 
poisoning, and should be ejected from the stomach promptly. 
Mucilaginous drinks and diluted vinegar may then be given 
liberally. 

Many facts could be stated to show that this, like other vege- 
table narcotics, is materially affected by culture, locality, &c. &c. 
This fact aids in solving many statements touching the delete- 



JALAP. 525 

rions action of small portions and the inertia of very large 
doses. 

Hyosciamin, the proximate principle of henbane, has been 
found useful as a sedative in cases of irritative cough. Professor 
Schroff says that, unlike morphia, this article promotes the action 
of the bowels. He gave it in doses varying from one-sixtieth to 
one-twentieth of a grain, mixed with sugar. One-tenth of a 
grain is quite too large a dose. It has greater power over the 
iris than any other agent in the Materia Meclica, inducing more 
prompt and long-continued dilatation of the pupil. The formula 
of Schroff for a solution is to add one part to ten of alcohol and 
one thousand parts of water. Twenty drops would be a dose. — 
American Druggists' Gazette, July, 1857. 

Hypnotic. — An article that induces sleep. The same with 
narcotic, as applied to opium. ; 

Jalapa Convolvulus. Jalap. — So called after Xalapa, a 
town in Mexico, near to which the root was procured in 1610. 
The root is the only part of this plant employed in medical prac- 
tice. When fresh, its juice is milky, a little acrid, and decidedly 
cathartic. As imported, we find the root much smaller than the 
drawings of the recent root, which is several times larger than 
the dried article. This difference is accounted for by reference 
to the spongy quality of the fresh root and the consequent 
shrinkage by the drying process. The imported root has rather 
a globular form, with some irregularity of surface. It has a 
resinous appearance when fractured, and is of a brownish-gray 
within. The powder has a peculiar, offensive odor, a nauseous 
taste, blended with a mixture of bitter and sweet. The very light, 
spongy, pale, worm-eaten, and inodorous roots are worthless. 

Jalap ranks among our best drastric cathartics, and is always 
most efficient in the state of powder. The tincture and extract 
are of no value to the profession, and never were. The ordi- 
nary adult close of the powder is ten grains, though some take 
fifteen or twenty grains ; sweetened water or syrup will be found 
a convenient vehicle. It is not often administered as a cathartic 
alone, but very frequently with ten or twelve grains of calomel. 
The mixture is a very efficient medicine. 

We also combine jalap with cremor tartar, and thus obtain 
what is called a hydragogue cathartic, or a medicine fitted to 
give copious, watery stools. It sometimes operates also as a 
diuretic. A drachm of jalap and two of cremor tartar, well 
rubbed together, make the mixture, which is to be divided into 
six powders, so that each will contain ten of jalap and twenty 
of cremor tartar. 

For the accommodation of persons who dislike the taste of 
jalap it has been incorporated with flour and made into biscuit; 



526 SKUNK CABBAGE — HOLLY. 

hence the term purgative biscuit, as found in De Foy's Materia 
Medica, 1843. Five drachms of jalap, thirty of sugar, and four 
ounces of flour are made into fifteen biscuits, after the usual 
mode. One of these given in the morning is a sufficient dose. 

Jalap is not necessarily a drastic cathartic. And even those 
persons who are griped and sickened by it can avoid these in- 
conveniences by combining with the dose a grain or two of cam- 
phor or three grains of cloves. 

I knew a physician who administered jalap not as a cathartic 
but rather as a nauseant. When he desired to prevent his pa- 
tient from eating too freely, and doubted the promises of absti- 
nence, he directed three grains of jalap to be taken one hour 
before each meal. The dose was just enough to take away 
desire for food, and thus the end was gained. 

The nauseous taste and smell of jalap can be wholly removed 
by digestion in sulphuric ether, and that too without lessening 
the cathartic power. 

In a publication made in the city of New York, it was an- 
nounced that eleven thousand pounds of jalap were condemned by 
the inspector of medicines in the course of six months in that city 
alone. The article came from Tampico, Vera Cruz, and Havana. 

Ice. (See Aqua.) 

Ictodes Fcetida. Draeontium Foetidum. SJcunJc Cabbage. 
Polecat Weed. — A common and well-known plant, found in wet 
meadows in many parts of the United States. The odor of the 
whole plant, and particularly of its large leaf, is offensive, the 
smell residing in a highly volatile matter that is dissipated by 
heat or by drying in the sun. The green leaves wilted in very 
hot water are employed in some parts of the country as a dress- 
ing to surfaces whence fly-blisters have been removed. 

The medicinal properties ascribed to the plant are various. 
It is called stimulant, antispasmodic , expectorant. Several good 
inaugural theses have been written on it in the western country, 
and these properties are strongly advocated. A half-drachm of 
the recent root in powder induces vertigo, sickness of stomach, 
and occasionally vomiting. It affords obvious relief to asth- 
matic and catarrhal affections. The best mode of administra- 
tion is in powder added to syrup at the time of exhibition. 
Some have advised to make a syrup of the plant in the usual 
way, but the process impairs the medicinal power. Ten grains 
of the powdered root, repeated every half hour or hour, will 
soon nauseate an adult, and thus secure its proper action. A 
very large dose will develop narcotic symptoms, as vertigo and 
temporary blindness. 

Ilex. Holly. — There are several species of this tree. The 
Ilex opaca is abundant in various parts of this country, more 



HOLLY. 527 

especially in New Jersey, Kentucky, Alabama, and Tennessee. 
It is very much like the European holly. It is introduced here 
because of its high repute some years ago as a substitute for 
Peruvian bark and sulphate of quinine, and because it can be had 
in any quantity in this country. 

Durant says that intermittent fevers yielded to a drachm of 
the powdered leaves given a half hour before the expected 
paroxysm. Dr. Rousseau has since spoken more fully on the 
subject in the Transactions of the Medico-Botanical Society of 
London for 1832-3, and a silver medal was awarded for his 
labors. A very good description and drawing of the tree is 
furnished in the English Flora Medic a of Barton and Castle, 
vol. ii. p. 3. Dr. R. employed the article ten years before he 
wrote on it, and regards it a valuable medicine, especially for 
the poor who cannot pay for the salt of quinine. He detected 
in the leaves a bitter, neutral, uncrystallizable substance, soluble 
in alcohol and not decomposed by acids or alkalies. To this he 
gave the name of ilicene. He obtained it by the following pro- 
cess : — A strong alcoholic extract was made of the holly leaves 
and diluted with water. To this he added sugar of lead, then 
sulphuric acid, and finally carbonate of lime. The ilicene being 
thus separated, was taken up by the action of alcohol. Two 
pounds of the dried leaves yielded more than two ounces of the 
active principle. It is not soluble in ether, and partially dis- 
solves in warm water. 

Dr. R. thinks that ilicene, as well as the holly leaves, exerts a 
sedative influence on the spleen, liver, and pancreas, that favors 
its curative operation in intermittents. He relates sixty-five 
cases treated successfully by the ilicene, in some of which the 
quinine salt had failed. 

A half-ounce of the leaves boiled in eight or ten ounces of 
water to one-half constituted a dose to be given two hours before 
the occurrence of the paroxysm, and repeated for eight or ten 
days if the disease did not sooner yield. The powder of the 
leaves was given in wine also. An extract was employed in pill 
form in half-drachm doses. The usual adult dose of the ilicene 
was twelve grains, gradually increased to eighteen or twenty- 
four, and given in the form of pill. 

Dr. Constatin found the mode of injection useful. A half- 
ounce of the leaves boiled a quarter of an hour in a little more 
than a pint of water, made a proper quantity, which induced 
free evacuations without griping. Long ago, Haller praised the 
juice of the leaves as a remedy for jaundice, but said nothing 
of its relation to intermittents. Reil confirms the testimony of 
Rousseau, and a good deal of interest has been excited in 
France touching the therapeutic value of the medicine. 



528 INDIGO — INFINITESIMAL PRACTICE. 

Indigo. — Product of the indigofera tinctoria. 

This article is of recent introduction, comparatively, and of 
limited use. Dr. Grosheim, of Prussia, first pointed out its value 
as a remedy for epilepsy. Dr. Ideler, a German physician, gave 
it to twenty-six epileptics, six of whom recovered, eleven were 
relieved, and six were not benefited at all. At first it vomited 
and purged smartly, but did not much impair the appetite. The 
paroxysms became less frequent and violent. The dose to begin 
with is a scruple, enlarged slowly to a drachm, and sometimes 
carried to a half-ounce. It should be combined with some aro- 
matic, and be given in syrup. The modus operandi is not stated, 
but its ultimate action would seem to be alterative and tonic. 

I gave this article a fair trial in an old case of epilepsy in the 
Louisville Marine Hospital in the winter of 1852-3. The patient 
was willing to take anything, so anxious was he to be relieved. 
Ten-grain doses, three times a day, were gradually increased to 
twenty, with no permanently good results. For awhile the fits 
were less frequent and less severe, but they resumed their former 
character. 

Infinitesimal Practice. — We prefer this to the term homoeo- 
pathy, which means similar affection, and does not set forth the 
reality of the system, if such it can be called. The true secret 
of this system resolves itself into the exceedingly minute bulk of 
the doses employed, to which may be added their accommodation 
to the taste. We know it is pretended that the pathogenetic or 
disease-producing power of remedies lies at the foundation of 
homoeopathy; but the real basis, practically, as an affair of 
naked popularity, is to be sought for only in the taste and size- 
of the close. Everybody who has read of the dilution of medi- 
cines understands well enough what is meant by infinitesimal 
doses and infinitesimal practice. Rub a grain of opium with a 
hundred grains of white sugar, and the longer you rub the 
stronger, medicinally, is the product. Take a grain of the 
mixture, add a hundred grains of sugar, and rub again. Of the 
mixture so made, take a grain and rub with it another hundred 
grains of sugar, and repeat the same process twenty times, and 
then determine, if you can, how much opium is in the final pro- 
duct of the mixture and trituration; and some faint idea may 
be formed of the actual inherent power of infinitesimal doses 
and of infinitesimal practice. We cannot waste more time on 
the subject. To make the effort would require a vast deal more 
patience than good old Job ever manifested or possessed. The 
man who can coolly swallow such a system is ripe for the 
credence of any absurdity no matter how impossible. In our 
view of the subject, it is really necessary for one to stultify him- 
self, to become actually demented, or intentionally to play the 



ITS RESULTS. 529 

knave, ere he can deliberately attempt to reconcile such a sys- 
tem with common sense and the acknowledged laws of the ani- 
mal economy. We may be mistaken, but cannot reach any other 
conclusion. 

The attempt to justify these almost invisible doses on the as- 
sumption that disease is intangible, spiritual, ethereal, and that 
the remedy must be kindred in its nature, is absolutely insane. 
Oh! it would be well for many an aching heart if the croup and 
laryngitis and pneumonia that have smitten their loved ones 
to the earth could be made to appear as intangible, spiritual, 
ethereal. Then might they find consolation in the fact that 
infinitesimal and intangible doses were heaven's only method of 
cure ; and that they failed because failure was inevitable. But 
the knife tells another story, when it discloses the frightful dis- 
organization of parts most essential to life aggravated and made 
positively incurable by the mad devotion to a moon-stricken 
philosophy. 

That infinitesimal doses may serve a good purpose where they 
are sure to come in contact with an imaginary disease or with 
no disease at all is just as palpable as the efficacy of bread pills. 
Nay, they may even do some good when the morbid action is so 
slight, though real, that nature unaided would do her own work 
in a vigorous constitution. But if there be real organic lesion, 
or the presence of a process that must end in disorganization, 
if not arrested, give me the steam-doctor, or the Dutch root-doc- 
tor, or any one else who approximates the adaptation of means 
to ends, but save me from the infinitesimal practice. 

The following extract from Bell's Bulletin of Medical Science, 
vol. iv., is a fair summary of this topic : — 

"The trials of homoeopathy at Berlin, authorized by the go- 
vernment, and conducted by two of Hahnemann's disciples in 
succession, were entire failures. Of twenty-five patients, selected 
by the first of the homoeopathic physicians himself out of several 
hundreds who were inmates of the hospital, not one was cured. 
In Russia a comparison of the two modes of practice — the ra- 
tional or allopathic, and the empirical or homoeopathic — was 
made, a distinguished follower of Hahnemann conducting the 
treatment on his side with a result eminently to the disadvan- 
tage of the latter. In another trial, in which patients in equal 
numbers were subjected to the homoeopathic practice on one part 
and to low diet and appropriate regimen (without any medicine) 
on the other, the result was the same in both cases. Whatever 
curative change was brought about was an effort of nature. The 
Medical Council, in reporting on those experiments, was of 
opinion that the homoeopathic practice should be prohibited in 






530 INFUSIONS. 

sanitary establishments dependent on government, for the fol- 
lowing reasons : — 

" ' 1. Acute diseases require energetic means of treatment, 
which are not to be expected from homoeopathy. 

" ' 2. The homoeopathic treatment of external lesions and sur- 
gical diseases is altogether out of the question. 

" ' 3. Some slight affections get well while under homoeopathic 
treatment, but similar affections disappear without any medical 
treatment by the adoption of an appropriate regimen, good air, 
and cleanliness.' 

" There are three sets of practitioners who profess homoeo- 
pathy, — one consistent, acting out their belief; another, who, 
under the pretence of giving homoeopathic doses, give common 
but small ones, and those of active and sometimes poisonous 
articles ; and the third set, who are ready to practice either way 
— allopathically or homoeopathically — thrifty knaves, who care 
not how they earn the silver provided it comes into their pockets : 
they pay the profession and their own judgment and science the 
odd compliment of asking their patients how they wish to be 
treated, and, according to the reply, will either bleed them or 
give them a Hahnemann vial to smell. Can we wonder that so 
many ignorant persons in the general community prate about 
systems of medicine, when they see such conduct in some of the 
professors of the art?" 

Infusions. — These differ from decoctions in being prepared 
with cold or hot water, but without ebullition. If a pint of boil- 
ing water be added to an ounce of vegetable matter and be 
allowed to remain in this state until cool enough to be taken, we 
call the remedy an infusion. But some articles are better pre- 
pared with cold water. For persons of delicate stomach we di- 
rect a cold infusion of quassia rather than an infusion made with 
hot water, because it suits the stomach better. A few pieces of 
calumbo-root placed in a pint of cold water will impart its bitter- 
ness sufficiently in eight or ten hours to make it a useful tonic 
drink. Hot water dissolves extractive and other matters not 
soluble in cold water, and hence the preference given to the cold 
infusion. It is needful to make but a small quantity of infusion 
at a time in warm weather, as the vegetable matter tends rapidly 
to decomposition. 

Infusions are made with hot or cold water as circumstances 
may require. The quantity should be small in warm weather, 
for fear of fermentation, unless the vessel can be kept in a cold 
place. Some patients can take infusions more readily than any 
other preparations, and they are often very efficient. We give 
a few specimens : — 



INFUSIONS. 



531 



Compound Infusion of Horseradish. 

Take of bruised mustard-seed, 

Scraped horseradish, aa ^ss ; 
Boiling water, Oi. 
Macerate for one hour, and strain ; 
then add 

Aromat. spt. amnion, gij ; 
Mix. Dose, a tablespoonful three 
times a day. 

Compound Infusion of Cloves. 

Take of bruised cloves, gi ; 

Orange peel, gij ; 

Coriander and 

Caraway seeds, aa gss ; 

Boiling water, R)i. 
Macerate for half an hour, and 
strain. 

Infusion of Bark and Sulph. Quinine. 

Take of best cinchona, in powder, £vi ; 
Boiling water, Oi. 
Digest for two hours in a close ves- 
sel, and strain ; then add 

Sulph. quinine, grs. viij ; 
Elix. vitriol, TT^xxiv. 
Mix. Dose, two tablespoonfuls three 
or four times a day. 

Infusion of Juniper. 

Take of juniper-berries, bruised, £ij ; 
Boiling water, Oi. 
Macerate in a close vessel for two 
hours, and strain ; then add 
Oil of juniper, gi ; 
Cremor tartar, ^ij. 
Mix. The dose is from two to four 
ounces four or five times a day. 

Compound Infusion of Horehound. 

Take of horehound, ^ ss ; 

Boiling water, ^viii. 
Macerate for an hour, and strain; 
then add 

Paregoric elixir, ^i ; 
Extract of liquorice, ^i. 
Mix, and take for a dose several 
times a day for chronic bronchitis. 

Compound Infusion of Hint. 
Take of horsemint, giss ; 

Rose leaves, ^i ; 

Boiling water, Oi ; 

Elixir of vitriol, gij ; 

White sugar, ^iss. 
Digest the mint and rose leaves in 
the water, and strain, adding the other 
articles afterward. The dose is a fluid- 
ounce or two, three times a day. 



Pectoral Infusion. 

Take of marshmallows, 

Balm, 

Spearmint, 

Elder-flowers, 

Arnica-flowers, aa ^i; 

Anise-seed, ^ss; 

Boiling water, a quart. 
Digest an hour, and use as a com- 
mon drink. 

Infusion of Rhubarb. 

Take of rhubarb-root, bruised, ^iss ; 
Boiling water, 3 viij. 
Macerate for two hours in a close 
vessel, and strain ; then add 
White sugar, ^ij ; 
01. menth. p. gtt. x. 
Mix. Dose, a tablespoonful three 
times a day. 

Compound Infusion of Rhubarb. 

Take of rhubarb-root, bruised, ^ss; 

Chamomile-flowers, 

Orange peel, aa giij ; 

Fennel-seed, 

Coriander-seed, aa gi ; 

Boiling water, ^xij. 
Macerate for two hours, strain, and 
add 

Carbonate of potash, gij ; 

Aq. cinnam. ^i. 
Mix. Dose, a tablespoonful or two, 
several times a day. 

Compound Infusion of Senna. 

Take of senna leaves, ^iss ; 

Manna, J-ij ; 

Cremor tartar, 

Bruised anise-seeds, aa gijss ; 

Bruised coriander, ^i ; 

Boiling water, Oij. 
Macerate for four hours, and strain. 
Dose, a wineglassful twice or thrice a 
day. 

Compound Infusion of Spigelia. 

Take of pink-root, gss ; 

Senna, gij ; 

Orange peel, worm-seed, and 

Fennel-seed, aa gi ; 

Boiling water, ^xij. 
Macerate for two hours in a close 
vessel, and strain. Dose, a wineglass 
half-full three to six times a day, as a 
vermifuge. 



532 INHALATIONS — IODINE. 

Inhalations. — The introduction of remedies into the system 
by inhalation is very ancient, and is entitled to much more re- 
gard than it now receives from the profession. Scudamore did 
a good deal, and deservedly, to revive this practice. Tar, hem- 
lock, vinegar, sulphuric ether, warm water, and some other arti- 
cles were so employed more than a hundred years ago. Mudge's 
inhaler was, and perhaps is yet, in some places, regarded a 
valuable instrument for this purpose. But as it is comparatively 
expensive, and not within the reach of all, it is well to recollect 
that a common funnel and a bowl will answer the end very well. 
The articles for inhalation are placed in a bowl so as nearly to 
fill it. A funnel is adapted to the bowl, and a towel passed 
round its edge so as to prevent escape of the vapors in that di- 
rection. The small aperture of the funnel is then placed in the 
patient's mouth, and thus inhalation is readily carried on. The 
contents of the bowl being hot, vapors necessarily pass off, and 
are easily received into the lungs and stomach. 

Dr. Mackay, and some others in Europe, believing that the 
cholera poison enters the system by the lungs, have resorted to 
inhalations of ethers, chloroform, and the like, in the hope of 
meeting the evil most promptly and efficaciously. In India as 
well as in England this practice has been very successful. As 
the articles just named evaporate spontaneously at the ordinary 
temperature, we are not obliged to resort to any inhaling appa- 
ratus for their use. Placed on a sponge or a handkerchief, they 
are speedily introduced into the system by applying the one or 
the other to the nostrils. 

The success attending the inhalation of sulphuric ether and 
chloroform in tetanus and hydrophobia, as reported in the 
foreign journals, should lead to trials of the same expedient 
in this country. The diseases named are so generally fatal that 
any means would seem to be justifiable that offer even a proba- 
bility of success. 

Injections. (See Clysters.) 

Iodine. — This is a simple, elementary, non-metallic, solid, 
bluish-black substance, having something of a metallic lustre. 
It is evaporated by gentle heat and passes off in the form of 
violet vapors. This can be effected by placing a portion in the 
palm of the hand, which is thereby stained of a brownish color, 
very much as it would be by nitric acid or bromine. The taste 
of iodine is decidedly acrid. 

The medicinal powers of several articles probably depend on 
iodine in some form of combination. The burnt sponge, formerly 
employed in the treatment of bronchocele, is known to contain 
iodine. Mineral waters, so highly praised for the cure of chronic 
diseases, accomplish their good results sometimes in virtue of the 



DISCOVERT OF IODINE. 533 

same ingredient ; and the far-famed cod-liver oil that is now so 
extensively popular is ascertained by careful analysis to contain 
a small quantity of iodine and bromine. 

Iodine was discovered in 1812. It was detected in preparing 
carbonate of soda from the ashes of sea-weeds. The metallic 
vessels employed in the process were found to be corroded by it 
at the bottom. On dropping a little sulphuric acid, dark-colored 
matter was thrown down which soon changed into a violet vapor. 
Further research proved this vaporized matter to be iodine, so 
called because of the purple or violet hue of its vapors. 

Since the date of its discovery, its value as a medicine has 
been so highly appreciated that vast quantities are annually 
manufactured ; and a good deal is sold that is spurious and con- 
sequently worthless. From September, 1848, to February, 1849, 
nearly five thousand ounces imported into the city of New York 
were rejected by the United States medical inspector. 

Shortly after the discovery of iodine an accident pointed out 
the proper test of its presence. If starch prepared with boil- 
ing water and then cooled be added to a solution suspected 
of containing iodine, a blue color will be struck and ioduret of 
starch formed. One part of iodine can thus be detected in 
450,000 parts of water. 

Iodine is known to exert a decided influence on the glandular 
and absorbent system, and to be a very valuable medicine for all 
kinds of scrofulous disease. Its earliest use was in the form of 
tincture, probably because it was ascertained that water could not 
dissolve it, or only in a very minute degree. 

An ounce of strong alcohol will dissolve from thirty-six to forty 
grains of iodine ; and of the tincture so made the adult dose is 
ten drops three times a day, increased if need be to ten drachms 
at a dose. It is readily taken in simple water, or in gum Arabic 
water. This tincture should never be made of weak alcohol, or 
if prepared thus it should be only as it is needed. The presence 
of water favors a change of the iodine into iodic and hyclriodic 
acids. 

I employed the tincture of iodine many years ago to remove 
small scrofulous tumors of the neck ; and I have good reason to 
believe that in dispersing them I succeeded also in annulling the 
diathesis that gave them birth. 

The dose employed was from three to five drops three times a 
day for a child eight years old, the tumors being rubbed gently 
with the same tincture. I hold the tincture therefore in high 
estimation. 

It is asserted by M. Lasegue, in the Revue Therap., that large 
doses of iodine may be safely given at meal time only. The un- 
easy sensation, amounting to gastralgia, is thus avoided. The 



534 TINCTURE OF IODINE. 

dose was increased from eight or ten drops to four scruples, and 
even a drachm and a half, during the meal. The medicine was 
given with Spanish wine or sweetened water. No iodism followed 
this practice. — W. Amer. Med.-Qhirurg Rev., May, 1857. 

Dr. Eulenherg, of Coblentz, tells us, in the Grazette Med. 
Etrangere, that he arrests the vomiting of pregnant ivomen 
promptly with small doses of tincture of iodine. One part of the 
common tincture is added to four and a half parts of rectified 
alcohol, and of this diluted tincture he gives three drops for a 
dose in a little water. Besides the anti-emetic effect, the remedy 
also calms the attendant cardialgia and gastralgia. The iodide 
of potassium has not answered so well. 

Dr. Headland, in his book on the Action of Medicines, page 
213, says he once met a medical man who denied the power of 
iodine altogether, because he had frequently taken a scruple, and 
even a drachm occasionally, without any effect. But many are 
soon affected by it in small portions, and evince the symptoms of 
iodism. In the one case, most likely, the medicine is fast elimi- 
nated by the kidneys ; in the other, it remains in the system for 
a longer time. 

The external uses of tincture of iodine have been and yet are 
quite numerous and important. The first to be named is in the 
treatment of a very common and annoying companion usually 
called corns. Four drachms of the tincture, twelve grains of 
iodide of iron, and four drachms of chloride of antimony are to 
be mixed in a common vial, and a portion applied night and 
morning, having first carefully pared away the horny surface of 
the excrescence. 

M. Bicord reports favorably of the application of the tincture 
to phagedenic ulcers. The ulcerative process is soon modified, 
and the cure greatly accelerated. The application is made three 
or four times a day with a hair pencil. 

The birth or strawberry marks, called ncevi materni, are easily 
obliterated by the use of iodine paint. The surface is coated every 
day, or every other day, with the paint or tincture, omitting it for 
three or four days if the skin becomes very irritable and rough. 
Sometimes two or three months' use will be necessary, for a com- 
plete removal; and where the knife is objected to this will be a safe 
substitute. 

Dr. John Davies published an excellent volume on the exter- 
nal use of iodine, in 1839, that ought to be in the hands of the 
profession generally. He employed the strongest tincture, and 
only externally, excepting in the single case of bronchocele. He 
added forty grains of iodine to an ounce of the purest alcohol ; 
occasionally he diluted this by a further alcoholic addition. 

This strong tincture was applied in erysipelas, especially of the 



INJECTIONS OF IODINE. 535 

face and scalp; in phlegmonous inflammation of the joints ; in 
mammary inflammation ; in swellings of the joints, gouty or 
otherwise ; in carbuncle, whitlow, chilblains, burns and scalds. 
A small, soft paint-brush was the instrument selected to make the 
application ; and frequently a single use of it was sufficient. 
The pain was relieved, the swelling abated, and the skin sepa- 
rated in a day or two by desquamation. From being very tense, 
the parts became flaccid. It was quite plain that the absorbents 
were stimulated to unwonted action. Now and then, after an ap- 
plication had been made of the strong tincture, the brush was 
laid on containing alcohol only. . This dissolved the matter de- 
posited on the surface, and the solution was really a weakened 
tincture whose agency was often beneficial. Rarely was it ne- 
cessary to apply the brush more than two or three times in any 
case. The operation, though occasionally a little painful, seldom 
excited complaint, and its good effects proved an abundant com- 
pensation. I have employed this plan with decided benefit, and 
think it worthy of notice. 

Injections of iodine have been employed with advantage in 
leucorrhoea, as follows : — 

Take of iodine, four scruples ; 

Alcohol, sixty scruples ; 

Water, one hundred and twenty-five scruples. 
Mix these until solution is complete, and throw thirty scruples into the 
vagina every night. 

A few injections have sufficed to arrest the disease. The 
remedy excites some heat in the parts, and slight tempo- 
rary irritation. It would seem to be well suited to scrofu- 
lous habits. — American Journal of Medical Sciences, July, 
1843. Chronic abscesses of the joints in scrofulous subjects 
have been treated in the same manner and by a solution of the 
same strength. The London Lancet for March, 1843, reports 
favorably of the tincture of iodine thus employed. My son, Dr. 
B. Rush Mitchell, of the U. S. Navy, treated a case of chronic 
abscess of the elbow joint very successfully on this plan, some 
years ago. Buboes in persons decidedly scrofulous, and therefore 
very obstinate, have been healed in a week by injecting the strong 
tincture of iodine into the cavity. (See American Journal of 
3Iedical Sciences, January, 1847.) Fistula in ano, long the 
subject of other treatment, has yielded speedily to the same kind 
of injection. 

The Edinburgh Medical and Surgical Journal, and some 
other periodicals, report cases of ascites cured by the tincture of 
iodine injected into the cavity of the peritoneum. But it strikes 
us that the expedient is one of considerable hazard. Doubtless 
it had its origin in the successful use of the tincture for the 
radical cure of hydrocele ; but the circumstances are dissimilar, 



536 INJECTIONS OF IODINE. 

To excite inflammation and adhesion of the tunica vaginalis so 
as to obliterate the cavity is a small affair, contrasted with the 
risk of setting up peritoneal inflammation, which would seem to 
be unavoidable when such an agent as the tincture of iodine is 
forced into contact with it. 

The London Lancet for June, 1850, quotes several very in- 
teresting cases from L' Union Medicate, to show the safety and 
success of iodine injections in the treatment of ascites. The 
case of a girl, aged seventeen, is cited, whose abdomen measured 
thirty-eight inches in circumference. After tapping her, the 
following injection was thrown in : — 

Tinct. iodin. ^i; 
Iod. potass, gi; 
Aquae, |viy. 

The patient experienced no pain : the abdomen was well 
kneaded, and about four ounces were thus forced out. The case 
did well. A more remarkable instance is furnished, with the same 
result. 

Obvious improvement in a case of internal chronic hydro- 
cephalus followed the use of iodine injections, and recovery would 
have ensued, says the writer, but for the very unhealthy locality 
in which the family resided. After drawing off the water, an in- 
jection of two ounces (made by adding fourteen drops of tinct. 
iodine to two ounces water) was slowly passed in by means of an 
ordinary hydrocele trocar. The child was evidently improved, 
and continued better during several days. The expedient is 
worth repetition. 

Several cases are reported in the Med. Times and Lancet for 
1857, of the use of iodine injections for the cure of ovarian 
dropsy, but they are far from being satisfactory. Prof. Simpson, 
of Edinburgh, has lately detailed some thirty cases treated with 
iodine injections. In some of these the good effects were most 
palpable, while in others there was more or less relief. In a 
few, no good result was gained, none at least of a permanent 
character. 

Dr. Churchill speaks very favorably of the application of 
iodine to the os uteri laboring under congestion and ulceration. 
The ulcers are touched once or twice a day with some other 
caustic first, after which the iodine is applied alone. The fol- 
lowing is his formula : — 

R. — Iodin. gi; 

Potass, hydr. gij ; 

Aquae, 

Alcohol, aa ^ij. 
Mix. 

(See Bankings Abstract, No. 10, page 267.) 

The tincture of iodine has been employed as an emmenagague, 



HYDRIODATE OF POTASH. 537 

externally, to the os uteri, with success, by Dr. Mikschik. 
Cases which had long resisted other means have yielded to this 
after the third day. — Med. Times and G-az., Oct. 1855. 

JSfcevi materni gradually disappear under the action of a tinc- 
ture of iodine made by dissolving a scruple in half an ounce of 
alcohol. Apply it freely once a day until the spot vanishes. 
The part scales off once in two or three days, and the system is 
not at all affected. — London Medical Gazette, August, 1849. 

Dr. Whitmire names the tincture of iodine as an excellent 
article for the bites of the rattlesnake, viper, and copperheads. 
He uses the strong tincture, applying it twice daily over all the 
swollen parts. The swelling is often promptly arrested by the 
time the third application is made. — Braithwaite s Retrospect, 
part xx. 

In addition to the above external applications of this medicine, 
it has also been employed with success to an old ununited 
fracture of the leg, to ulcers of the throat and fauces, to the 
outside of the eyelids in scrofulous inflammation of the con- 
junctiva, to prevent pitting and scarring by small-pox, &c. 

Iodine is sometimes employed in the shape of ointment, a 
drachm being well rubbed with an ounce of simple cerate for this 
purpose. A piece as large as a medium nutmeg well rubbed into 
the throat excites high irritation of the skin, and thus gives re- 
lief when the throat and fauces are inflamed and when incipient 
quinsy is present. It proves stimulant, rubefacient, discutient, 
and thus effects the removal of tumors. Friction always gives 
increased activity to the ointment, and should be made when it 
can conveniently be clone. Dr. Leigh has strongly recommended 
this ointment in cases of phthisis pulmonalis, and especially in 
the early period of tubercular development. He directs a por- 
tion to be placed in the axilla close to the skin, the patient being 
in bed, with his head covered, in order to confine the iodine vapors. 
The animal temperature softens the ointment, the tender axilla 
is smartly irritated, and the iodine is eliminated in the form of 
vapor, which is necessarily inhaled. The ointment should be 
thus applied every night for weeks. It allays cough, and arrests 
the development of tubercle. 

Iodine is much in use in the form of the hydriodate of potash, 
or, as it is often called, the iodide of potassium. When these 
terms are employed in medical works they are to be understood 
as precisely synonymous. The article can be made by evapora- 
ting to dryness a saturated solution of iodine and potash. The 
residue is to be fused in a platina crucible, so as to exclude the 
external air. The absolutely dry article is properly iodide of 
potassium, which moisture changes to hydriodate of potash. 
The salt is very deliquescent, and should be kept in well-stop- 

35 



538 USES OF THE HYDKIODATE. 

pered bottles. When perfectly pure it is white, but frequently 
has a slight tinge of yellow. It is very soluble in water, and 
is generally exhibited in aqueous solution. Forty-eight grains 
to the ounce of water give a mixture the adult dose of which is 
from ten to thirty drops three times a day. Much stronger solu- 
tions are frequently administered with safety and success. 

Lehmann says if iodide of potassium (in pill) in moderate or 
large dose be administered, iodine may be detected in the saliva 
in ten minutes. — Headland's Action of Medicines, p. 317. 

The actual therapeutic properties of the iodide or hydriodate 
have not been well denned, nor is it easy to state what those pro- 
perties are, in a brief definition. I think the facts connected 
with its exhibition as a remedy, together with the results, prove 
it to be better entitled to the appellation of universal alterative 
than any other medicine. Its successful exhibition in long-con- 
tinued rheumatism, almost hopeless from the failure of all other 
means, seems to make this title just. I have never known a 
medicine, nor any combination of medicines, to effect such signal 
changes in chronic rheumatism as this article has accomplished in 
a few weeks. The most obvious effect in those cases was the 
great increase of urinary discharge, and thus a large portion of 
the materies morbi was probably eliminated. In the case par- 
ticularly referred to, three-grain doses were given at first, and 
increased daily until thirty or forty grains made the dose. 

In the Grazette Medicale, 1843, Dr. Aubrun says he has em- 
ployed the iodide of potassium for years, both in acute and chronic 
rheumatism, with success. He gave his adult patients from one 
to five scruples in twenty-four hours. If the medicine disagreed 
with the stomach, the accident was ascribed to some free iodine. 
In some instances, salivation ensued, and appeared to depend on 
the action of the medicine. Dr. A. thinks it more generally 
successful in acute than in chronic rheumatism, and affirms that 
no bad consequences followed. 

Dr. Pickett, of Louisiana, reports success in the management 
of rheumatism in the far South, with sixteen grains of the iodide. 
(See New Orleans Med. and Surg. Journ. for Oct. 1844.) 

This medicine proved successful in the last stage of acute 
hydrocephalus in a child two and a half years old. A drachm 
was dissolved in half an ounce of water, and thirty drops of the 
mixture were given every hour in a glass of water. This treat- 
ment was persisted in for weeks, and then half the dose was 
administered for a short time. (See American Journ. Med. 
Sciences, Jan. 1842.) 

A practice somewhat similar was reported by Dr. Seyffer, a 
German practitioner, in 1843. From eight to twelve grains of 
the iodide were dissolved in three ounces of water, and a dessert- 



USES OF THE HYDRIODATE. 539 

spoonful administered to a child two years old every two hours. 
If the patient was lymphatic and puffy he gave the following 
additional mixture : — 

Take iodine, one grain, and dissolve it in 

Alcohol, two drops ; rub the mixture with 

Calomel, seven grains; 

Sugar, two and a half drachms. 
Mix well together, and divide into thirty-two parts. 

One of these powders was given three times a day. At the 
same time the forehead and temples were rubbed with an oint- 
ment made of eight grains of protiodide of mercury and half an 
ounce of lard. 

The essentially scrofulous origin and nature of hydrocephalus 
internus may serve to explain the success of the iodine prepara- 
tion, and in this relation it merits special notice. 

Baudelocque was in the habit of treating all sorts of scrofulous 
disease in children with this medicine. An eighth of a grain was 
dissolved in an ounce of gum-water, or in syrup, for a dose ; and 
three, four, five, or even ten doses, were given daily, according 
to the age of the child, and in some cases larger doses. The 
solution keeps very well in close vessels. (See Repertoire Cli- 
nique de Villard, vol. iv.) 

A writer in the Medic o-Chirurgical Review for April, 1837, 
speaks of the emmenagogue powers of the hydriodate of potash. 
This medicine was given in ten-grain doses daily, for about two 
months, to a female laboring under secondary syphilis. She 
had been without her catamenia for four years, and now the dis- 
charge returned, and continued to recur at the proper periods. 
We suppose the action of the medicine depended on its high 
alterative operation. 

Ricord announces that he has found the iodide of potassium 
decidedly valuable in allaying gastric irritation, as the effect of 
distant local disease. He gave it in the infusion of quassia. 
Two drachms are dissolved in two pounds of the infusion, and 
half a wineglassful is given three times a day. (See London 
Lancet, April, 1850.) 

Hydriodate of potash has also been eminently useful in cases 
of suppressed measles and scarlatina. Every well-instructed 
physician is aware of the clangers attending a sudden recession 
of those eruptive diseases, and also the importance of a speedy 
return to the surface. The reporter declares that the medicine 
under consideration induces healthful reaction under the most 
untoward circumstances. For a child between eight and twelve 
years old he gives a solution of three grains in a few ounces of 
sugared water, so as to have the whole consumed in twenty-four 
hours or less. The mixture determines to the skin very promptly 



540 USES OF THE HYDRIODATE. 

and efficiently. The throat is washed at the same time with 
tincture of iodine, so as to irritate the skin. (See Braithwaite s 
Retrospect, part vii.) 

A valuable paper by M. Melsens, translated by Dr. William 
Budd, and published in the Brit, and For. Med. Rev. originally, 
may be seen in part xxvii. of Braithivaite, at page 239 and on- 
ward, treating of the use of iodide of potassium as a remedy for 
the affections caused by lead and mercury, by which the author 
meant lead and mercurial poisoning, no doubt. His theory is, 
that "The metallic poison is located in the blood; that the iodide 
mingles with it, forming a new and soluble salt; liberates the 
poison from its union with the system, dissolves it out, so to 
speak, from the damaged fibre, and sets it afloat, to be carried 
out of the body." The double iodide of mercury, or lead and 
potassium, he thinks, is the new product, which is eliminated by 
the kidneys. An adult may begin with ten or fifteen grains 
three times a day, gradually rising to a drachm in twenty-four 
hours. 

Mr. Sankey, of Sussex, England, has treated cases of ague, 
which resisted sulph. quinine, with iodide of potassium, with de- 
cided benefit. The disease had been of long standing and the 
patients were feeble. The prescription was thus : — 

R. — Potass, iodid. ^iss; 
Aq. menth. pip. 3xij. 

Mix. Take two large tablespoonfuls four times a day, adding, sometimes, 
one grain of sulph. quinine to each dose. — Assoc. Med. Journal, March, 1856. ' 

Dr. Dean read a paper before the Virginia Med. Society, to 
show the success of the iodide of potassium in three cases of 
asthma. A clergyman of Illinois, who had been cured by using 
the remedy, gave him the information. The dose was eight 
grains every four hours. 

The hydriodate of potash and mercury, in form of syrup, has 
been successfully employed in secondary syphilis in scrofulous 
subjects. It is made by adding one part of deutiodide of mer- 
cury and fifty of hydriodate of potash to fifty of pure water. 
Filter the solution through paper, and add of clear syrup two 
thousand four hundred parts. The dose is a tablespoonful three 
times a day. It is not an unpleasant medicine, and may be kept 
a long while unchanged. 

The tenesmus of dysentery has been happily met by an injec- 
tion of iodine one and a half grains, iodide of potassium fifteen 
grains, in a convenient vehicle, as flaxseed tea or barley-water* 
The injection was repeated, sometimes twice a day, for three 
days, and was followed by feelings of great comfort. M. Eimer 
first called attention to this use of iodine. — N. Amer. Medico- 
Qhirurg. Rev., May, 1857. 



lugol's solution. 541 

An ointment of the hydriodate is occasionally used, and the 
following will be found a good formula: — Dissolve the requisite 
quantity of hydriodate in distilled or aromatic water, and then 
mix it well with the proper amount of lard. This is far better 
than the old plan of mixing the salt and the lard at once. The 
ointment will remain good a longer time. A drachm to an ounce 
of lard is the customary proportion. This ointment has proved 
a useful application to ulcers in persons of a scrofulous habit. 

Dr. Ogier Ward has treated itch with a solution of iodide of 
potassium, and sometimes found a single washing to suffice. He 
occasionally employed sulphur ointment in the night, and the 
wash during the day. Rarely did it require longer than a week 
to cure. The lotion was made of a drachm of the iodide to 
eight or sixteen ounces of water, according to the delicacy of the 
cutaneous surface. (See London Lancet, July, 1846.) 

The following preparation of hydriodate of potash forms a 
sort of liniment not unlike Steer's opodeldoc, and is often an 
admirable substitute for the ointment spoken of above. Dissolve 
an ounce of the hydriodate in four ounces of strong alcohol, and 
in another vessel dissolve an ounce and a half of animal soap 
in four ounces of alcohol. Mix these solutions and aromatise 
with any of the essential oils. Pour it, while fluid, into wide- 
mouthed bottles, and keep them well stoppered. A solution in 
water of iodine and hydriodate of potash constitutes LugoVs 
solution. If we dissolve from thirty to fifty grains of the salt in 
water, the solution will readily take up from five to ten grains of 
iodine, making a reddish-brown solution, first introduced by 
Lugol, and presenting one of the best methods for using iodine. 
The adult dose of this solution is ten drops three times a day, in 
syrup, and gradually increased. A solution twice as strong is 
often employed at the same time, externally, as a lotion to the 
eyes affected with scrofulous ophthalmia, cutaneous diseases, &c. 
The internal and external operation of the remedy are com- 
bined in such cases with signal benefit. In 1832, I treated a 
very obstinate case of lepra nigricans, that had been under treat- 
ment in several southern hospitals to no good purpose, with this 
combination most successfully. A case of scrofulous ophthalmia, 
of like obstinacy, was cured by the same treatment in a few 
weeks. These patients were in the Cincinnati Hospital, and 
under my charge, as one of the attending physicians. 

LugoVs solution, called also the iodureted hydriodate of pot- 
ash, is sometimes made of much greater strength for internal use 
than the preparation above named, and it may be made a good 
deal weaker, if desired. 

The following formula has been tried with good effect in the 
dropsy consequent on scarlatina, whether in children or adults ; 



542 IODIDE OF STARCH. 

and it is probable the cases were essentially scrofulous, although 
it is not so stated in the London Medical Gazette for 1842, 
whence this is extracted: — 

R. — Iodine, ^i; 

Iod. potass, ^y; 

Aquae, gvij; 
Mix. 

The dose for young children is from five to ten drops three 
times a day; for adults, from ten to twenty-five drops, taken in 
sweetened water. The medicine is said to abate inflammation 
and to promote absorption. 

Herpetic prurigo of the perineum has been promptly relieved 
by the following compound, which is only another variety of 
Lugol's solution: — 

R. — Iodine, thirteen grains; 
Hyd. pot. forty grains; 
Alcohol, one ounce; 
Water, five ounces. 
Mix carefully, and use as a lotion morning and night. [London Lancet, 1843.) 

The iodureted solution has also been efficacious in the treat- 
ment of hydrarthrosis and kindred affections of the joints, and 
especially of the knee. One part of iodine and two of the hy- 
driodate are dissolved in fifteen parts of water and employed 
as an injection. In the cases named blisters were first applied 
repeatedly, and an opening into the joint prepared the way for 
the injection. (See Bulletin Med. Sciences, Aug. 1843.) 

Inhalations of iodine have been tried, with encouraging results. 
The observations and experiments of Ganal on the inhalation of 
chlorine led the way for the use of iodine in the same manner. 
The mode of impregnating a room is very simple. A watch- 
crystal containing iodine may be floated on warm water in a 
saucer, or by any other easy contrivance, and the vapors will 
soon escape and mingle with the air of the apartment. These 
vapors are sometimes beneficial to persons laboring under irrita- 
tive cough. Even in pulmonary consumption they may prove a 
palliative. 

Iodide, or Ioduret of Starch, has been named already. It 
has been employed as a remedy in the Glasgow Infirmary by 
Dr. Buchanan. (See Lond. Med. Gazette, 1836.) He rubbed 
twenty-four grains of iodine with an ounce of starch and enough 
water to mix thoroughly. The mixture was slowly dried, so as 
to avoid the separation of the iodine. To preserve it for use it 
must be kept in tight bottles. The dose to begin with is three 
grains three times a day, but seventy-two grains were given at 
one dose without injury. The starch evidently modifies the 
quality of the iodine, and hence it is the best antidote for an 



iodism. 543 

over-dose. This blue compound was found very useful in scro- 
fulous diseases, and appeared to suit some persons better than 
any other preparation of iodine. 

Iodide of arsenic is made in the dry or wet method, as may 
be preferred. Boil three parts of pulverized metallic arsenic 
and ten of iodine in one hundred of water till the smell of iodine 
is gone, and then evaporate rapidly to complete dryness. The 
iodide is a bright, brick-red, crystalline substance, volatile, and 
readily fusible by a gentle heat into a deep blood-red fluid, 
which on cooling concretes into a deep-red crystalline mass of 
metallic lustre. It has no smell, and a faint metallic taste. 
The ordinary dose is from a sixteenth to a tenth of a grain two 
or three times daily, and may be given in pill or in watery solu- 
tion. It has been found useful in intermittents in scrofulous 
subjects. 

An old case of psoriasis inveterata in a baker, and affecting 
his arms and legs and scalp, was cured in less than three months 
by the use of the iodide of arsenic. He had been treated on 
various plans by distinguished practitioners, without benefit. 
After the use of a warm bath and some purgative medicine he 
was put on the twelfth of a grain of the iodide made into a pill 
with liquorice powder, and repeated three times a day. The 
dose was gradually increased to a sixth of a grain three times 
a day until the 3d of May, when he was discharged cured. Occa- 
sionally the medicine was omitted for a few days, and a cathartic 
administered. The diet of the patient was milk all the while. 
(See Braithwaite, part xx.) 

Iodide of sulphur has acquired popularity as a remedy for 
scrofulous itch, or for itch in persons of a scrofulous habit. It 
is very readily made by incorporating the ingredients, and is 
employed as an ointment. 

Iodide of quinine was introduced as an article specially suited 
to scrofulous constitutions that could not well bear the ordinary 
salt of quinine. It may no doubt be a valuable medicine in such 
cases. 

The term iodized oil is to be seen in some of the journals; and 
it is proposed as a more efficient agent than cod-liver oil. Iodine 
is incorporated with sweet oil or with cod-liver oil, so as to make 
a solution possessing augmented iodine power. It has been in 
use for some years in England, and has been employed occasion- 
ally in this country. 

The term iodism requires an explanation. We mean by it 
any unpleasant gastric or intestinal derangement attending the 
use of any iodine medicine. These effects are now and then per- 
ceptible, and call for treatment. One of the best plans is to 
lay the remedy aside for two or three days, and then renew it. 



544 IPECACUANHA. 

Another is to give at intervals an acidulated solution of sulphate 
of quinine. Sometimes mere attention to the diet and the bowels 
will suffice. I have never experienced any difficulty so serious as 
to prevent the necessary perseverance in the use of the medicine. 

Allusion has been made to adulterations of iodine. The one 
that I have noticed particularly is effected by addition of fine 
particles of stone coal, which have been added to the extent of 
a third of the mass. Take a portion of such iodine, say a tea- 
spoonful, and heat gently in a saucer. All the iodine will escape 
in form of violet vapors, and the coal, being unaffected by such 
a temperature, will remain. 

The iodide of potassium is also frequently adulterated. Other 
salts are added that augment its deliquescence and enfeeble its 
powers. I have judged of the comparative purity of this article 
chiefly by its iodine strength, thus ascertained: — I placed in an 
oil flask a tablespoonful of sulphuric acid exposed to the heat of 
a spirit-lamp a few minutes. A piece of the iodide was then 
dropped into the flask, about the size of a medium nutmeg, and 
instantly a dense volume of iodine vapors rushed out. The denser 
the volume the purer was the salt supposed to be. I am aware 
that this test is not strictly accurate, and yet it will be found 
pretty satisfactory. 

lodognosis. — M. Dorvault has used this term to denote all that 
is understood by the therapeutical and medical properties of 
iodine. — London Medical Gazette, January 10, 1851. 

Ipecacuanha. Callieocea Ipecacuanha. Ceplicelis Ipecacu- 
anha. — The title ipecacuan has been given to several other 
plants, which need not be named here. The origin of the word 
is ipe, root, and cacuanha, the name of the district where it was 
first found. 

Decandolle supposed that ipecacuanha properly meant the 
vomiting root. Piso first noticed its peculiar qualities in 1618 ; 
in 1672 it was brought to Europe, and in 1686 it was examined 
carefully by Helvetius, in Paris. It is stated that Louis XlVth 
assisted Helvetius in bringing the plant into notice as a remedy 
for dysentery, that being the first regular remedial use to which 
it was applied. For his faithful and assiduous labors in these 
investigations the government awarded to Helvetius the sum of 
one thousand pounds. From that time it became one of the 
most popular medicines in England and Germany. It is one of 
the articles of Materia Medica that has never lost much of its 
original and well-deserved popularity in any part of the civilized 
world, and at this day, in this country, it is in very high esti- 
mation. 

The name Callieocea was given to it by a botanical professor 
in Portugal, in the year 1800, and an accurate description and 



IPECACUANHA. 545 

drawing were then exhibited, and afterward published in the 
Transactions of the London Linnosan Society. 

Ipecacuanha is a perennial plant, growing in shady places, in 
forests, in moist spots in Brazil and various parts of South 
America. The roots are creeping and horizontal, like threads or 
twines of variable size, having small tubercular eminences or 
rings. It has been called annulated, because of the ring-like 
formation. The root is often of the thickness of a goose-quill, 
smaller or larger according to circumstances. It is irregularly 
knotted and branched, being covered with a brown epidermis. 
It consists of two portions, viz., the ligneous or woody, which is 
inert, and the cortical, or active part. When the root is broken 
by a sudden snap it presents a kind of resinous fracture, and 
yet it contains no resin. It has a bitterish, acrid, nauseous 
taste. The odor is faint and herbaceous, and is easily separated, 
as is also the taste, by digestion in sulphuric ether. The proxi- 
mate principle on which the energy of ipecacuanha depends was 
discovered in 1817, by Pelletier, and called emetin. He found 
it to exist in the best roots to the quantity of sixteen per cent. 
The entire residue of the root is destitute of medicinal properties. 

Infusion of nut-galls, or anything that contains tannin, will 
throw down a precipitate when added to a solution of ipecacuanha. 
The precipitate is tannate of emetin, and is inert. Iodine causes 
a red precipitate, which is iodide of emetin. Acetate of lead 
also throws down a precipitate. Salts of iron blacken the solu- 
tions of ipecacuanha. We infer the incompatibility ', thence, of 
tannin, sugar of lead, iodine, &c, with the solutions of ipeca- 
cuanha. 

Ipecacuanha is sometimes adulterated by admixture with the 
powder of other roots, and the fraud cannot well be exposed. 
But if tartar emetic be added, as it has been to make the ipeca- 
cuanha appear to be very potent, that may be detected pretty 
readily. Dissolve the preparation in water slightly heated, filter, 
and add to the clear solution a little hydrosulphuret of ammonia. 
If tartar emetic be present, an orange-red precipitate (red sul- 
phuret of antimony) will be produced. — Adulteration of Medi- 
cines, page 101. 

Before we notice the therapeutic applications of the powder of 
ipecacuanha, it is proper to advert to some interesting facts in- 
volving the doctrine of idiosyncrasy, and which all physicians 
should bear in mind. It is not known to all medical men that 
the bare smell of the smallest fragment of this article will induce 
distressing asthma in certain persons, and this not accidentally 
but invariably. Those who desire full information on this inte- 
resting point are referred to a paper by Dr. Felix Robertson, 
one of the oldest and most respectable graduates of the Uni- 



546 IPECACUANHA. 

versity of Pennsylvania, residing in Tennessee. (See American 
Journal of Medical Sciences, January, 1844.) This paper was 
issued also in form of pamphlet, and was largely circulated in 
the West. 

But the case of Dr. Robertson is not alone ; many other per- 
sons of high respectability, both male and female, having been 
the subjects of precisely the same peculiarity. And the lesson 
taught is, simply, to be governed by this and any other medicinal 
idiosyncrasy, in the administration of remedies. 

As early as 1759, violent asthmatic fits were induced by 
proximity to ipecacuanha, as we learn from a paper by Dr. Scott, 
published in the Medical Commentaries, vol. ii. page 317. In 
addition to the case therein named, others are referred to of a 
like nature. 

The mere inhalation of the dust of ipecacuanha has been found 
so to act on the lungs as to induce bronchitis ; and yet this medi- 
cine has been very much trusted by some as a remedy for that 
disease. 

As an emetic, ipecacuanha is more extensively employed than 
any other article of Materia Medica. The powder is generally 
preferred. It is of a bright, light-gray color, and possesses the 
qualities already ascribed to the root. The adult dose for full 
vomiting varies from a scruple to a drachm, and should be given 
in warm water, the quantity varying from two to four ounces. 
A good plan is to add a drachm to six ounces of boiling water, 
and allow it to stand until the temperature is sufficiently reduced 
to enable the patient to swallow it. One-third of this may be 
given every half hour or twenty minutes until the desired effect 
is obtained. A single portion will sometimes suffice. 

The article made as above is sometimes called ipecacuanha 
tea, and is a good medicine for young children laboring under 
colds of greater or less severity. Kept on a stove or elsewhere, 
so as to be a little warm, it may be administered in tea or table- 
spoonful doses through the day, so as to vomit or nauseate, as 
may be most desirable. I have often prescribed it in this way 
with happy results. 

Now and then the physician will be perplexed by failing to get 
an emetic action, both in adults and young children. The fault 
lies in neglecting to deplete the patient before exhibiting the 
ipecacuanha. This is certainly true of inflammatory croup, and 
is really so in some affections of adults. I was called at mid- 
night to see a man laboring under something like severe colic. 
Not having a lancet with me, and supposing I could relieve him 
by an emetic, I gave ipecacuanha. His supper had been of very 
indigestible articles, and in larger quantity than usual. The pro- 
priety of emetic treatment seemed quite obvious. Fomentations 



IPECACUANHA. 547 

and sinapisms were freely employed. Dose after dose of the 
ipecacuanha was given, and no vomiting nor purging. Injections 
were resorted to, and evacuations per anum obtained. The man 
fell asleep after two or three hours, and I did the same, and my 
patient awoke nearly as well as usual ; but he had not been 
vomited, nor scarcely nauseated by the emetic doses, amounting, 
in all, to nearly two drachms. He was sufficiently vigorous to 
have borne the loss of fifteen ounces of blood, and I have no 
doubt if the detraction had been made when I first saw him, the 
first dose of ipecacuanha would have emptied his stomach. 

Some physicians employ the wine of ipecacuanha in prefer- 
ence to the powder in the cases of children, who take it more 
readily. I have never found it necessary to resort to it, and 
think it Can well be dispensed with. Those who desire to use it 
can readily prepare it by digesting for two weeks two ounces 
of the powder of ipecacuanha, moderately fine, in a quart of old 
sherry wine. Filter and bottle for use. From ten to thirty 
drops prove expectorant and diaphoretic. From two drachms to 
half an ounce will vomit an adult. 

The London Medical Gazette for 1847 says that the wine of 
ipecacuanha is the best application to parts bitten by venomous 
insects. It arrests the pain instantly. 

It is probable, when ipecacuanha is given as an emetic in the 
usual way, that the first effect is that of local irritation of the 
mucous membrane of the stomach. But as the emetic action is 
generally delayed about half an hour, it is probable that the 
emetin is separated in that lapse of time by the agency of the 
gastric juice, and absorbed into the circulation. Through that 
medium, and also through the medium of the nervous system, an 
impression reaches the parts more directly involved in the act of 
vomiting, and the result is finally manifest. Among the advan- 
tages sometimes assigned to ipecacuanha over other emetics a 
prominent one is its failure to teaze the patient by repeated 
efforts to vomit. One or two evacuations of the stomach take 
place, and then the excess passes off by stool. As a consequence 
of this, the vital forces are far less depressed than when tartar 
emetic is exhibited, which not unfrequently operates by vomiting 
and stool in close succession. Another valuable feature is that 
its action is unattended by painful spasms of the stomach or 
bowels. As it does not impair the tone of the stomach, even 
by repetitious use, to any appreciable degree, it is preferable to 
tartar emetic, especially in the diseases of children, to whom we 
have very frequently to administer emetics of some kind or 
other. 

When it is desirable to augment and to protract emetic action 
in adults, it is well to add a grain of tartar emetic to the usual 



548 THE ORIGINAL DOVER'S POWDER. 

dose of ipecacuanha. This is especially proper when we appre- 
hend a slight amount of inflammatory action in the system, and 
for which we would not choose to bleed. 

Combined with opium and a little neutral salt, ipecacuanha 
plays a happy part in the well-known Dover s powder, which 
usually contains, in every ten grains, one of opium, one of ipeca- 
cuanha, and eight of sulphate of potash. This mixture is some- 
times called the compound powder of ipecacuanha, and is given 
most advantageously at bedtime to tranquilize the system and 
set up a gentle perspiration. The ordinary dose for an adult is 
ten or twelve grains, followed by an occasional draught of warm 
tea or barley-water. After depletion, this medicine is very often 
employed in ordinary rheumatism, acute or chronic, and not un- 
frequently with good results. 

The Dover's poivder of the present day is not the same thing 
with the original preparation, as we learn from The Ancient 
Physician s Legacy to his Country, published by Dover. That 
work directs opium, an ounce; saltpetre and vitriolated tartar, 
each four ounces; ipecacuanha, an ounce; liquorice, an ounce; 
to be well triturated after exposure of the salts to heat. The 
dose was from forty to seventy grains in warm drink, taken at 
bedtime, and it contained from four to nine grains of opium. 

A valuable use of ipecacuanha is to accelerate the operation 
of cathartic medicine. Three grains added to fifteen of jalap 
and five of calomel will hasten the action of the latter con- 
siderably, and prevent or lessen the drastic tendency. The mix- 
ture not only purges actively, but generally induces sweating. 

We said that the earliest use of ipecacuanha was in dysentery. 
It is yet and ever will be regarded with favor in the treatment 
of that disease. The plan of Sir John Pringle has always ap- 
peared to me to be the best. He gave five grains of calomel 
with five grains of ipecacuanha every hour or half hour until 
four or five doses were taken. The effect was free vomiting and 
purging, with a complete checking of bloody discharges in many 
instances. Sometimes the lancet was employed prior to this 
mixture, and should be if the state of the system made it ne- 
cessary. 

Very frequently have I put this practice to the test, and I 
prefer it decidedly to any other treatment. In addition to the 
vomiting and purging, a free perspiration is induced. If the 
bowel evacuations were not sufficiently copious, a dose of castor 
oil with ten drops of laudanum, given on the next day, accom- 
plished the object. As a local application, I know of nothing 
equal to a very large and soft bread and milk, or mush poultice, 
applied hot, and large enough to cover the whole abdomen. It 
should be renewed every four hours. 



USES OF IPECACUANHA. 549 

The diet should be gruel, arrow-root, sago, boiled milk, milk 
and mutton suet boiled together, and the like. Injections of 
milk and mutton suet are often very good adjuvants. It was a 
very common practice many years ago to cure dysentery with a 
drachm of ipecacuanha and sixty drops of laudanum, preceded 
by a full dose of Glauber's salt. The ipecacuanha followed 
the purgation, and, last of all, the laudanum was given. (See 
Memoirs of Lond. Med. Soc, vol. v. p. 212.) 

Ipecacuanha will also be found a good medicine in diarrhoea. 
It acts in that disease very much as in dysentery, by correcting 
the action of the mucous membrane of the stomach and bowels. 
This I hold to be the secret of its success. At first it may be 
given in doses large enough to vomit; after which, very small 
portions, say two or three grains every four hours, will suffice, 
adding occasionally an eighth of a grain of sulphate of morphia. 

In spasmodic asthma, common catarrh, and stricture of the 
chest, so common in pulmonary consumption, ipecacuanha is often 
promptly beneficial in doses of three to five grains, given every 
two or three hours. Menorrhagia of high as well as low morbid 
action has been treated successfully with ipecacuanha by Dr. 
Osborne, of Dublin. He gives a scruple at bedtime, followed 
next morning by a saline cathartic. The discharge was promptly 
checked, and if it happened to return, the same treatment was 
repeated. M. Caffin first noticed this practice in vol. lxix. of 
the Journal G-enerale de Medecine. He remarks that the dis- 
charge ceases almost immediately after the emetic action of the 
ipecacuanha. The principle involved is probably the same as 
that which associates syncope with arrest of hemorrhage from 
ordinary causes. 

A saccharized extract of ipecacuanha has been highly com- 
mended by a writer in the New York Journal of Medical 
Sciences for 1854, because preferable to the usual preparations 
of ipecacuanha. It is made thus: — 

Take of ipecac root four ounces, bruise to a coarse powder, 
and macerate for thirty days in sixteen ounces of diluted alcohol, 
shaking occasionally. Then filter and express. Evaporate the 
tincture so obtained to twelve ounces, with which mix ei^ht 
ounces of white sugar, and rub the whole in a mortar until quite 
dry. The product is of a brownish-yellow color, and quite solu- 
ble in almost all the usual menstrua. The dose is twice that 
of the powdered root. Its sweet taste renders it agreeable to 
children. 

Ipecacuanha liniment has been introduced into practice rather 
recently in the treatment of chronic hydrocephalus, incipient 
'phthisis pulmonalis, infantile convulsions, chronic inflammation 



550 EMETIN — WHITE WALNUT. 

of the synovial membrane of the knee, and in certain rheumatic 
affections. 

An infant eight months old had convulsions, squinting, vomit- 
ing, &c. &c. Nitrate of potash and ipecacuanha were given in- 
ternally, and the following liniment was applied to the scalp : — 

Take of ipecac. 

Sweet oil, aa gij ; 

Lard, 5ss. 
Mix. 

This was rubbed into the scalp, during fifteen or twenty 
minutes, three or four times a day, and the head covered with 
flannels. In thirty-six hours, or sooner, numerous small papulae 
and vesicles appeared, and these assumed a true pustular cha- 
racter, ran together and became confluent. This state of the 
scalp continued for several days. The child recovered. (See 
Edinburgh Medical and Surgical Journal, Oct. 1843.) 

In the same journal is an account of the good effects of the 
same liniment frequently rubbed on the chest of a person who 
had incipient phthisis. The cough ceased on the appearance of 
the eruption. 

We named emetin as the active principle in ipecacuanha. 
There are two kinds mentioned by writers, viz., the colored and 
the colorless. The latter is more pure and energetic than the 
former ; indeed, it has quite <too much potency for ordinary use. 
The only advantage possessed by either over ipecacuanha, is 
the absence of unpleasant taste or smell. Four grains of colored 
emetin, in divided doses, will act as an emetic. This quantity 
should be dissolved in a half-ounce of lemon syrup and two 
ounces of water, and given in tablespoon doses every half hour. 
Two grains of pure emetin will kill a large dog. A sixteenth 
part of a grain vomited an old man severely. One grain in a 
little acetic acid and water, taken at a dose, will vomit a man of 
thirty with considerable severity. It is therefore not a very 
safe article, and not at all equal, as a general emetic, to ipeca- 
cuanha. 

Juglans Cathartica. White Walnut. Butternut. — This 
tree has been known as possessed of medicinal properties ever 
since the first settlement of America, and long before. It fur- 
nishes one of the very best native cathartics, and is so appre- 
ciated where it is most employed. The surgeons in the army 
of the American revolution were compelled to rely on it almost 
exclusively, from necessity, as it was not possible to procure 
foreign articles during a part of that eventful struggle. 

The white walnut has an advantage over most cathartics in 
its more favorable action on the mucous coat of the bowels, 
whereby it leaves the canal less liable to costiveness than any 



JUNIPER BERRIES. 551 

other purgative. Hence in part its great popularity as a family 
medicine. 

The inner bark of the roots furnishes the best extract. Many 
persons are not select in this respect, and hence they get an in- 
ferior article. The best time for collecting the bark is in June. 
It should be cut into very small pieces, and boiled in pure water. 
A pound of the root and a gallon of water should be boiled to 
four pints. Strain while hot, and evaporate slowly and care- 
fully to avoid burning, until the whole is of the consistence of 
soft extract. When quite pure and unburnt, it has a sweetish 
odor, a rather bitter astringent taste, and is nearly black. The 
dose may be twenty to thirty grains if active purgation be de- 
sired, and a smaller portion if a mere aperient effect is sought 
for. It is sometimes combined with calomel, with good effect. 

The decoction is occasionally taken as a cathartic, but the ex- 
tract is more pleasant, and also more certain. 

A cordial of the bark has long been in use in country loca- 
tions as a remedy for the bowel complaints of children. The 
bark is to be well broken and beaten so as to make a soft, stringy 
mass, which is to be placed in an earthen vessel, closely packed 
down. Boiling water is then poured in, sufficient to cover the 
whole; and the vessel is to be plaeed on bright coals for about 
two hours, the vessel being closely covered. The whole must 
then be strained, and sugar enough added to the clear liquid to 
make a syrup. This is to be bottled, a little alcohol or brandy 
being added to each bottle in order to preserve it. The dose 
for a child a year old is a tablespoonful, repeated till it acts 
smartly on the bowels. 

Juniper Berries. Baccce Juniperi. — As we often get these 
berries, they are generally of little value. When fresh and sound, 
and properly managed, their diuretic property is important. 
They contain an essential oil, and on this their activity depends. 
Old berries have lost all their oil, and are worthless. The round, 
plump, bright-black and sound berries are the best. 

To make the berries available they should be so bruised with 
a hammer as to break the seeds, for in them the oil resides. An 
ounce of berries so prepared should be added to a pint of boil- 
ing water with a very little cinnamon, taking care to cover the 
vessel tight. When cold, this infusion may be taken in wine- 
glass doses frequently. It is used in dropsical affections. 

Linnaeus says the Laplanders drink the infusion as we drink 
common green or black tea. The Swedes make beer out of the 
berries, which they hold to be diuretic and antiscorbutic. 

Dr. Sully reports very favorably of the oil of juniper as an 
application for the relief of scald head. His formula is as fol- 
lows : — Oil of juniper, an ounce and a half; lard, two ounces ; 



552 USES OF KINO. 

essence of aniseed, six drops ; to be rubbed well together. The 
ointment is to be applied to all the parts affected, and has proved 
equally useful in scrofulous ophthalmia, scabies, and eczema. I 
would repeat here the advice several times given, to act on the 
stomach and bowels by calomel and ipecacuanha at the same 
time. (See Journal de Medecine et de Chirurgie., Nov. 1846.) 

Dr. Reuth called the attention of the profession, in 1853, to 
two preparations, regarded by him as important in the treatment 
of eczema. The one is the oily product of the destructive distil- 
lation of juniper wood, called liuile de cade; the other is juniper- 
tar ointment, prepared from the oil named in proportion of half 
an ounce to one ounce and a half of lard. The ointment is ap- 
plied locally, as other salves, with no other treatment save a due 
regulation of the bowels. This last is of the utmost consequence 
in all shin affections, and no permanent cure can take place if 
it be neglected. — Braithwaite, p. xxix. p. 250. 

Kino. — This has been called a gum, but is probably neither 
a gum nor a resin. Some parcels may have shown slight evi- 
dence of gum and resin, but when quite pure both of these fail. 
The plant it comes from has always been matter of dispute, and 
it is yet as doubtful as ever, nor is it at all important to have it 
settled. We could do without the article altogether, inasmuch as 
we have numerous astringents that are preferable. The Nauclea 
G-ambir is named as one of the sources, and is believed to -fur- 
nish the India kino. Whatever be the source, the predominant 
principles in the product are tannin and extractive. Brandy, 
or diluted alcohol, is a good solvent, and furnishes a tincture that 
has a large amount of astringency. As a proof that this is not 
resinous, the addition of water does not make it milky. 

By some kino is regarded as a valuable astringent. Fother- 
gill first brought it into notice as a remedy in diarrhoea caused 
and kept up by general relaxation of the mucous membrane of 
the bowels. He combined it with opium in pyrosis accompanied 
with pain. The opium soothed the gastric uneasiness, while the 
kino gave tone to the mucous membrane. As an injection it has 
been employed in gonorrhoea and leucorrhoea, but is not proper 
if high inflammatory action is present. For the relief of a 
relaxed condition of the uvula and fauces a watery solution 
has been usefully employed, as a gargle, to cleanse the parts and 
act by its astringency. 

Kino was formerly exhibited alone, or with tonics, in the 
treatment of inter mitt ents, but the practice has long since fallen 
into disuse. 

The dose of this medicine, in powder, is from ten to sixty 
grains, and can be taken in molasses, or syrup of ginger, or in 
sweetened water. The watery infusion is preferable to the tine- 



KOUSSO — LACTUCARIUM. 553 

ture under all circumstances where mere astringency is needed. 
From two to four drachms of bruised kino and a half-drachm 
of cinnamon bark digested for an hour in a pint of boiling 
water make a good infusion. The mixture should be made in 
a covered vessel, and strained as soon as it becomes cold. The 
dose, a tablespoonful from three to six times a day, according to 
the urgency of the case. Dr. Elliotson remarks of kino and 
catechu, as remedies for bowel disease, that the watery infusion 
is as good as any other mode of administration. The tincture 
is easily made, by digesting an ounce of kino in a quart of 
brandy. The dose is from one to three drachms. 

The alkalies, lime, corrosive sublimate, and tartar emetic are 
among the incompatibles of kino. 

Kousso. Hagenia Abyssinica. — When full grown, this vege- 
table has the size of an ordinary fruit tree. The medicinal power 
is in the flower, which must be dried with care, freed of stalks, 
and then reduced to a fine powder. The dose varies from six 
to eight drachms, taken in cold water early in the morning. It 
usually acts in two hours, and has been known to expel a large 
tape-ivorm in the third or fourth evacuation. — Ranking's Ab- 
stract, vol. i. p. 88. In addition, we find facts of like tenor in 
Braithwaite s Retrospect, and the London Lancet. 

We have never employed the kousso, but are induced to re- 
gard it as a very good anthelmintic, and specially suited to 
tape- worm. 

Lactucarium. — This is a kind of extract somewhat like opium 
in color and anodyne properties, but lacking the objectionable 
qualities of opium. It is obtained with little trouble from the 
garden head-lettuce by wounding or bruising the white, solid, 
central portion of the mature plant. A milky juice flows out, 
which, after a slow evaporation by exposure to the air and a hot 
sun, acquires the consistence of an extract. Its taste is some- 
what" bitter, and its color nearly as brown as that of opium. 
The best lactucarium and the most is obtained from the juice 
taken when the plant is in flower and about to form the seed. 

Aubergier regards the alcoholic extract of lactucarium as the 
best preparation. He directs the strongest alcohol to be em- 
ployed, and the evaporation to be conducted on the water-bath, 
the mixture to be constantly stirred. The extract so procured 
is brown, very bitter, and not deliquescent. Homolle names a 
case of insomnia, after typhoid fever, accompanied with severe 
epistaxis, in which the alcoholic extract was of great service 
after the salts of morphia had failed. He began with a grain 
and a half, increasing the dose to between four and five grains, 
in the form of syrup. 

Dr. John Redman Coxe, formerly Professor of Chemistry and 

36 



554 LARKSPUR. 

Materia Medica in the University of Pennsylvania, published a 
good paper on this article in the Transactions of the American 
Philosophical Society, which the reader can consult. I have 
known families in the West to prepare this medicine as a domes- 
tic substitute for opium, preferring it much to the latter, and 
finding it more pleasant. The dose is from two to four grains, 
which are conveniently administered in form of pill. It can be 
used a much longer time, without apprehension as to ultimate 
consequences, than opium can. Some have added it to ipecacu- 
anha and sulphate of potash to make Dover's powder, omitting 
the usual quantity of opium. 

One of the most agreeable methods of exhibition is in the 
shape of syrup, made by rubbing a drachm of lactucarium with 
a little water and adding Jo a pint of lemon, or ginger, or simple 
syrup, as may be most agreeable. The late Professor Eberle 
was in the habit of prescribing this syrup of lactucarium for 
nervous and hysterical females who could not, or thought they 
could not, take any preparation of opium. The dose is from one 
to two ounces, repeated as circumstances may require. 

Larkspur. — Common garden larkspur, found in gardens al- 
most everywhere, is so familiar to almost everybody as to 
require no particular description here. The plant is about two 
feet high, and abounds with variegated flowers, of white, blue, 
and red. It is a species of delphinium — the delphinium con- 
solida of Linnaeus. 

I call the attention of my medical brethren to it because it is 
always within their reach and because of its valuable anti-emetic 
property. More than forty years ago I experienced great em- 
barrassment in my efforts to control the vomiting of autumnal 
fevers, prevalent near to the Philadelphia Lazaretto, where I 
was stationed as physician of the establishment. I was induced, 
by the representations of a worthy old lady, to make trial of the 
larkspur leaves and flowers, in the form of infusion. The re- 
medy acted, as some would say, like a charm. It was quite 
nauseous at first, but gave such delightful relief that the patient 
begged to have the dose repeated. I never knew it to be re- 
jected. On the contrary, it calmed the stomach speedily. 

The infusion was made of half an ounce of the leaves and 
flowers, added to a pint of boiling water. The dose, a wine- 
glassful, to be given every half hour, or more frequently if ne- 
cessary. 

For want of a better therapeutic appellation, I have called 
this medicine an anti-emetic ; but regard it as displaying sedative 
qualities also. 

A few words are said touching the use of larkspur in affections 
of the eyes, in calculous complaints, as a vermifuge and as a 



LAUEUS SASSAFRAS. 555 

diuretic, in the American edition of Christison' s Dispensatory; 
but no allusion is had to the peculiar property named above. 
The United States Dispensatory is equally silent on this point, 
noticing the plant pretty much as Christison's American editor 
has done. 

A proximate principle, called delphina, has been separated 
from the larkspur ; but it has not attracted special notice. 

Laurus Sassafras. — This is an article so universally known 
in all parts of the country that it would be a waste of time to 
enter into details in order to describe it. The sassafras bark is 
one of the most common domestic articles for the preparation 
of a pleasant beer, and to make a family tea to purge out the 
bad humors in the spring, as the matrons would say ; for they 
are all by nature humoral pathologists. 

The root, wood, and flowers are all employed for various pur- 
poses in domestic and professional practice. All possess agree- 
able qualities, and are remarkable for a peculiar warm, aromatic 
taste, as well as an agreeable odor. 

The younger shoots of the bark yield a pithy substance that 
contains a good deal of mucilaginous matter, which is readily 
extracted by water. 

The peculiar properties of sassafras reside in a volatile oil, ob- 
tained by distillation of any and every part of the plant ; hence 
the well-known oil of sassafras. 

Hot water very readily extracts all the active qualities of sas- 
safras, and hence the family tea of which mention has been made. 
Drank warm, this fluid acts kindly on the skin, giving rise to a 
pleasant diaphoresis. On this account, most probably, the bark 
and wood are added to sarsaparilla, lignum-vitae, and other in- 
gredients in the diaphoretic diet-drinks so much employed in 
some regions. 

A very strong decoction of the bark and wood is employed in 
the West, as an antiseptic, in form of poultice to ill-conditioned,, 
foul ulcers. Sometimes the powder of the bark is sprinkled over 
a bread and milk poultice with the same intent. 

The bark and oil are employed as carminatives ; the bark in 
shape of tea, and the oil dropped on sugar or made into an 
emulsion. 

The mucilaginous solution procured from the pith is a pleasant 
application to inflamed eyes, especially after general and local 
depletion. It is also a convenient and useful demulcent, well 
suited to diseases of the chest, to derangement of the bowels 
and urinary organs. The proper proportions for making this 
solution are two drachms of the pith and a pint of hot water. 
When the solution is cold, it should be strained, if intended for 
the eyes. 



556 LEECHING. 

From two to ten drops of the oil may be taken by an adult in 
the manner stated above. 

Leeching. — This is a very valuable expedient in practical 
medicine, and whenever within reach it should not be overlooked. 
It serves for depletion in parts on which we cannot so effectually 
operate in any other way. 

The leeches employed in this country are imported from abroad, 
or obtained in the neighborhood of our large cities. Those 
gathered in the vicinity of Philadelphia are able to abstract 
about a drachm of blood, so that forty would draw five ounces ; 
and if to this we add the fact that as much more may often be 
taken by fomentations to the leeched spot, we can readily per- 
ceive the extent of this depleting agency. 

One of the objections raised to leeches in country places is 
the difficulty of preserving them. It was found to be a very 
troublesome part of their history forty years ago, in the Phila- 
delphia Almshouse, and no doubt will yet be somewhat embar- 
rassing. One of the best methods is to keep them in loose turf 
or moss, kept constantly moist, and packed in vessels which 
admit of a free renewal of air all the while. They have been 
well kept in glass bottles two-thirds full of water, renewed every 
two or three days, and covered with fine gauze. It is quite im- 
portant to regulate the temperature so as not to allow it to fall 
below 50°. There should be free ventilation in the room where 
leeches are kept, and all strong odors should be excluded. As 
soon as a leech is known to be dead, it should be instantly re- 
moved, and fresh water applied. 

With strict attention to the precautions above named, leeches 
may be preserved in an active state for many months without 
food. They are, however, subject to epidemic depredations, that 
destroy vast numbers in spite of all the care that can be given. 

To insure the most efficient leeches, gather a quantity in the 
hand and squeeze them suddenly, yet gently. The most active 
will be found to have contracted themselves into a wrinkled oval 
ball, and they should be kept out of water before they are used. 
If they be kept in a dry clean bag of muslin, and the part to be 
leeched be perfectly clean, they will be found to act at once. 

The practice of smearing milk or cream or blood on the part 
in order to make the leeches take hold, and the dipping them for 
a moment in porter, presuppose some defect in the leeches them- 
selves. And besides all this it is notorious that they will not act, 
however vigorous, on parts impressed by poisonous or strongly- 
scented articles. 

Various devices are in use to restore leeches, after having been 
employed once or oftener,.to their original state of activity. It 
is necessary to rid them entirely of the blood they have imbibed, 



ICELAND MOSS — LEMONS. 557 

in order to employ them soon again. The evacuation is effected 
by mere pressure, stripping them gently between the fingers, 
having first applied a few grains of common salt to the mouth. 
The most recent plan is to put them in a glass vessel half full of 
water, with an inch or less of sand at the bottom, and a quarter 
of an ounce of white wine, changing the fluid every day until the 
fourth day, and then employing pure water. 

Leeches can be applied to any part of the body, while cups 
must necessarily be restricted to certain portions. As they ac- 
tually make incisions in the more delicate structures, their appli- 
cation may be followed by fatal bleeding. Cases of this kind 
have occurred, especially in young subjects. Should a leech get 
into the stomach, it can be speedily destroyed by the introduction 
of some strong solution of common house salt, which is decidedly 
poisonous to it. 

Pressure, all the astringents, stick caustic, the actual cautery, 
and taking up the part by ligature, have been resorted to in order 
to arrest the bleeding from leech-bites. A weak solution of 
creosote and collodion have also been strongly recommended. 

Lichen Islandicus. Cetraria Islandica. Iceland Moss. — 
This was formerly lauded as a remedy for pulmonary consump- 
tion, but never accomplished anything in that relation. It 
abounds in a mucilaginous and slightly bitter fecula, and the 
most that can be afiirmed of it is that it is a bland nutritive, a 
demulcent, and therefore slightly a pectoral. 

The moss is easily prepared for use by washing five drachms 
in cold water to remove foreign matters, then digesting in 
a pint and a half of boiling water for two hours in a covered 
vessel. Then boil down to a pint, and strain while hot. From 
three to six tablespoonfuls will be found to be a good demulcent, 
and gently tonic. A little lemon-juice improves it. 

The following formula for making jelly of Iceland moss and 
cod-liver oil merits notice : — 

Of jelly of the moss, made in the usual way, thirty-two drachms ; 

Of gelatine, four scruples ; 

Cod-liver oil, to which add two drops essence bitter almonds, thirty-two drachms. 

Dissolve the gelatine in some water, and pour it into the ves- 
sel containing the moss jelly. Heat the whole and add the cod- 
liver oil, stirring well until the mixture is perfect. From two to 
six or eight tablespoonfuls may be given at a dose. In trouble- 
some coughs this combination may be valuable. — Bull, de The- 
rapeutique. 

Limones. Lemons. Fruit of the Citrus Medica. — The peel, 
the juice, and the oil are employed variously. The first is an 
adjuvant to bitters and nauseous medicines. It is stated that 



558 LEMON-JUICE AND SYKUP. 

chewing a small portion of the dried peel just before and after 
swallowing the usual dose of cod-liver oil deprives the latter of 
its unpleasant taste. 

The juice is very largely employed for making one of the most 
grateful beverages for those in health and for the sick. Lemon- 
ade made of the fresh juice is always more pleasant than when 
prepared by dissolving the purest citric acid, or acid of lemons. 
The following is a good mode of using the fruit : — Take of the 
freshly-expressed juice, four ounces ; half an ounce of the skin 
or peel; four ounces of white sugar; three pints of boiling 
water. Mix the whole in a clean pitcher with a cover, and strain 
when cold. 

The juice is also employed in the preparation of real, genuine 
lemon syrup, a valuable article for medicinal and dietetic pur- 
poses. Take of strained lemon-juice, a pint ; of refined sugar, 
two pounds ; dissolve the sugar in the juice and simmer over a 
slow fire for half an hour. When cold, bottle and cork with 
sound corks. The syrup thus prepared will always be an excel- 
lent substitute for the fresh juice when it cannot be obtained. 
It is quite another thing from the so-called lemon syrup, manu- 
factured and sold by the hundred thousand dozens and more 
every year. This sham compound has not a particle of the lemon 
in its composition, save about ten or fifteen drops of the oil added 
to each bottle which contains the syrup of tartaric acid. 

No fluid so well allays thirst as lemonade, whether it be made 
of the fresh juice or by adding water to the genuine syrup. Dr. 
Marshall, deputy inspector of military hospitals in British India, 
traveled on foot over a vast territory in India, and found nothing 
that could allay thirst so certainly and effectually as lemon-juice 
and water. This and kindred testimony, furnished by most re- 
spectable men in all countries, is proof conclusive that ardent 
spirits are not necessary, as some have contended, as a beverage 
in tropical climates. 

In hemorrhages, and febrile affections generally, iced lemonade 
is often a valuable adjunct. If there be a slight degree of nausea 
present, it may be well to add a half-teaspoonful of bi-carb. sod. 
to each tumbler of the lemonade, so as to create an effervescent 
draught, which should be swallowed quickly. The fresher the 
fruit the more grateful will be the lemonade made from it ; but as 
we cannot always obtain lemons, nor citric acid, we must rely on 
the juice of the fruit carefully preserved in bottles by adding an 
ounce or two of brandy or alcohol to each quart bottle. 

Lemon-juice is sometimes evaporated by a slow heat till a solid 
salt is procured. In this form it is brought from Jamaica, and 
found to be very pleasant. A scruple dissolved in water equal 
in bulk to the juice of a lemon, makes a solution of equal acidity. 



PROPERTIES OF LEMON-JUICE. 559 

Lemon-juice has been regarded in the light of an antiseptic, 
tonic, and antiscorbutic ; to which I add that, paradoxical as it 
may seem, it is a real antacid. The antiseptic quality was an- 
nounced many years ago in consequence of the obviously good 
effects obtained from its use in what was called putrid dysentery. 
A Dr. Wright administered it alone, and saturated with muriate 
of soda, and relied on these medicines exclusively. He gave 
the same articles in what he called putrid sore throat, not only 
as a gargle, but also to be swallowed. Whatever may be thought 
of the theory or practice of this physician, no one doubts the 
antiscorbutic qualities of lemon-juice, for these are palpable to 
the most casual observer. There can be no doubt £hat this acid 
alone could prevent the appearance of scurvy on shipboard 
during the longest voyage, and its curative character is equally 
certain. One or two tablespoonfuls daily will be sufficient, es- 
pecially if good potatoes be employed as part of the diet, and 
if care be taken to ventilate and keep absolutely clean every 
part of the vessel and her crew. When scurvy makes no other, 
manifestation but in the gums, as we often see on the land, es- 
pecially in scrofulous females, the free daily use of lemon-juice, 
and gentle friction of the gums with the inside of fresh lemon- 
skin, will speedily arrest the tendency to bleed and give firmness 
to the texture. 

Some facts recorded in the Medico-Ohirurgical Review of 
1824 seem to prove that lemon-juice alone, unaided by a suitable 
diet, will not always exert a favorable influence on scurvy. We 
presume, however, that its influence, added to such a diet, will 
always be salutary. 

In some parts of Russia lemons are successfully employed in 
very hopeless cases of dropsy. On the first day one lemon is 
given, the peel being removed and the substance cut into small 
pieces, mingled with white sugar. On the two following days 
three are given in the same way, and after that eighteen per day. 
The patients are to subsist chiefly on animal food. The effusion 
quickly passes off, and hence the remedy, most likely, acts as a 
diuretic. 

The antacid power of lemon-juice is a point that will be re- 
garded as absurd and paradoxical to the last degree. But as I 
speak from personal experience as well as from practical application 
in others, what is to be affirmed may be considered as entitled to 
attention. And in saying that I have found the lemon-juice to be 
antacid I do not intend to preclude the idea of a previous tonic 
action as the basis of the final result. What I mean to aver is 
this : acidity of the stomach, persistent and distressing in its 
nature, after resisting all the ordinary medicines called antacid, 
finally yielded to strong lemonade and the unmixed juice of the 



560 LEMON-JUICE ANTACID. 

fruit. A mere casualty led to the use of the article, viz., the 
thoughtless act of sucking the contents of a lemon, and the im- 
mediate relief in the stomach as the result. The previous disa- 
greeable feelings associated with an acid state vanished, and no 
discomfort remained for several hours. The lemon-juice was 
then resorted to intentionally in the pure and mixed forms named 
above, and the effect was so obvious as to admit of no doubt. 
The hardest old cider acted very much in the same manner on 
several occasions. 

The facts had been mentioned to a colleague in the West, who 
appeared to be a little skeptical as to the power of an acid to 
cure acidity, not in infinitesimal doses, but in full draughts. That 
gentleman happened subsequently to have a very embarrassing 
case of gastric acidity on hand. The patient was a lady of some 
wealth and respectability, and exceedingly anxious to lose a trouble- 
some companion. The lemon-juice was named to her, and imme- 
diately put to the test. The result was entirely satisfactory to 
patient and friends as well as to the physician. 

The explanation is not impracticable. A writer has taught 
(Dr. Dick) that acidity may result from deficient tone of the sto- 
mach, and that the restoration of lost tone will enable the mucous 
coat to pour out the pure natural secretion, and not the morbid 
fluid which constitutes the acidity so much complained of by 
many persons. If this be a correct view we are at no loss to 
understand how the lemon-juice operates. It is in virtue of the 
tonic quality ascribed to it by all the books, and which it un- 
doubtedly possesses. Whether this be so or not I can confidently 
commend this remedy for the purpose herein named, and advisee 
that a trial be made of it for days or weeks after other and more 
common means have signally failed. 

As far back as the year 1778, Dr. Pearce (England) was very 
successful in the treatment of bilious remittents, fevers of a low 
type, and a variety of diseases, by the use of tablespoonful doses 
of lemon-juice, associated with the application of sheets or towels 
soaked in ice-cold water to the surface. We have noticed the 
fact under the article aqua, and refer the reader for details to 
the works of Dr. John C. Letson, a name familiar to medical 
readers. 

It is well known that lemon-juice (and orange-juice also) has 
long been a very popular remedy for epidemic influenza. It 
controls in a wonderful manner the great depression and attend- 
ant flux of the tissues so troublesome in this disease. It seems 
to act, as in scurvy, by depurating the blood rather than by re- 
storing anything that is deficient. Dr. Golding Bird has put the 
question emphatically, " Can we, at will, by therapeutic agents, 
produce a depuration of the system, and by hastening the meta- 






USES OF LEMON-JUICE. 561 

niorphosis of matter aid the removal of a materies morbi?" I 
think we have no reason to give a negative reply so long as the 
lemon-juice practice furnishes so many affirmative proofs. 

The most recent employment of lemon-juice noticed in the 
journals is in the treatment of rheumatic gout. I need hardly 
say that the remedy seems about as inappropriate here as for the 
cure of gastric acidity; for the popular feeling has ever been ad- 
verse to the use of acids of any kind in any form of gout. But 
we live in progressive times. 

Dr. Rees, assistant physician to Guy's Hospital, furnishes the 
facts to which we have reference at this time. He had a female 
patient, aged eighteen, laboring under acute articular rheumatism, 
or rheumatic gout, and suffering intense pain. After purging with 
calomel and rhubarb, he gave half-ounce doses of lemon-juice in 
a little camphor mixture three times a day. In five days the dis- 
ease had left her, and the only additional means were tonics to 
recuperate the enfeebled system. 

Dr. R. says, "I first had recourse to lemon-juice for the cure 
of rheumatic gout, from a belief that the vegetable acids con- 
tributed to effect the transformation of the tissues generally, 
and because lemon-juice was the most palatable form in which 
that class of remedies could be exhibited. It seemed probable, 
moreover, that the supercitrate contained in the juice, though 
in small quantity, was a form of alkaline salt likely to contribute 
to the alkalinity of the blood in its transformations ; knowing, 
as we do, from the examination of the urine, that such organic 
compounds become converted into carbonates during digestion 
and circulation." 

Dr. R. further adds, " I have been for several months in the 
habit of prescribing this remedy with such marked and rapid 
benefit, that I am unwilling to delay its announcement to my 
brethren. The early relief from pain was such that any one 
unacquainted with the course pursued would have inferred that 
the patient was under the action of some of the best sedatives." 
(See Braithwaite, part xix.) 

In a discussion at the London Medical Society, several physi- 
cians bore testimony to the efficacy of lemon-juice in the treat- 
ment of rheumatism, and Mr. Headland announced that he had 
found the same article exceedingly valuable in qbstinate dys- 
menorrhoea. 

The editor of the London Medical Gazette thinks that Dr. 
Rees has succeeded in demonstrating the remedial powers of 
lemon-juice in rheumatism, and supposes that it acts by elimi- 
nating morbid matter from the kidneys very much as colchicum 
does. (See Braithwaite, part xx. p. 40.) 

Dr. Babington reports much success in the use of six-ounce 



562 USES OF LEMON-JUICE. 

doses every four hours, no untoward symptom resulting. And 
we may add, without citation of other authorities, that in this 
country and abroad the confidence of the profession in this re- 
medy has largely increased during the past five years. That it 
has not always succeeded we are well aware. 

Braithwaite s Retrospect, from part xxiii. to xxxiv., furnishes 
proof in abundance of the value of this agent, although it was 
once held to be an impracticable remedy. 

Dr. Owen Rees has shown that the lemon-juice is more apt to 
fail in chronic than acute rheumatism ; and that in pseudo- 
rheumatic disease attending what is usually called Bright's 
kidney affection, and which sometimes complicates spinal dis- 
ease, the lemon-juice signally fails. But it is decidedly, in his 
judgment, the most certain remedy for unmixed acute rheu- 
matism. 

Diluted lemon-juice has proved a good application for the 
relief of pruritus of the scrotum ; it should be made morning 
and evening, the parts having been well washed with soapsuds. 

The oil of lemon, in doses of from one to five drops, is some- 
times given as a carminative. 

It is said that overseers and slaves in the far South frequently 
cure the bilious fevers of that country by the use of hot infusions 
of green lemons and oranges, drank freely after purging with 
calomel, and rubbing the extremities smartly with the green 
fruit cut into slices.* 

Lemon-juice would seem to be decomposed in the system; for 
Dr. Rees, who has given it in very large doses, has never known 
it to increase the acidity of urine, however much it augments 
the quantity. The matter is certainly involved in obscurity, 
while we cannot doubt that the remedy is decomposed and new 
compounds formed out of it. 

And in respect of the use of lemon-juice to correct acidity of 
stomach, as in my own case, there can be no doubt that there is 
a decomposition of the remedy ultimately, for it does not leave 
behind a token of any acid product consequent on its use. 

The experiments of Dr. Bence Jones show that the action of 
lemon-juice on the animal system is in all respects identical with 
that of free citric acid. The positive experience of Dr. Lonsdale, 
who treated scurvy on a broad scale in Cumberland, England, as 

* For the removal of freckles, so disquieting to many females, the following 
mixture, known as the Parisian freckle water, will be acceptable. It is more safe 
than some in use : — 

Finely powdered alum, an ounce ; 
Lemon-juice, an ounce ; 
Eose-water, a pint. 
When the solution is complete, apply it two or three times a day. 



USES OF LEMON-JUICE. 563 

well as that of other physicians, is in direct confirmation of the 
position that lemon-juice owes its remedial efficacy to this acid. 
We think the question is fully settled. 

Dr. M. L. Knapp, late Professor of Materia Medica in a 
Western school, has published several tracts, in which he has 
ingeniously and forcibly attempted to show that cholera epi- 
demica, cholera infantum, the nursing sore mouth, puerperal 
anaemia, yellow fever, &c. &c. &c, are only so many forms of 
scurvy ; and he thinks that the old writers held substantially 
the same opinion. Hence his high estimate of lemon-juice, 
citric acid, orangeade, vinegar, punch, fruits, &c, aided by 
nutritious soups, beefsteak gravy, &c, as almost infallible reme- 
dies. He is also very fond of the free use of sulphate of quinine 
as an important adjuvant. 

In bowel affections he has named the following mixture as first 
employed to quiet gastric and intestinal irritability, after which 
the lemon-juice and kindred articles find their proper place : — 

]&. — Tinct. rhei comp. 

Tinct. catechu, 

Mucilag. acacise, 

Syr. simp, aa ^i; 

Morph. acet. gr. i; 

Sod. bicarb. 

Amnion, carb. aa ^i. 
Mix. 

Of this the sucking mother was ordered a teaspoonful in a 
little good brandy-toddy every three hours, her infant taking 
forty drops in a teaspoonful or two of the toddy at like intervals. 
This treatment, Dr. K. supposed, prepared the way for the ex- 
hibition of lemon-juice. He also, at the same time, invigorated 
the mother with good punch and sulphate of quinine. 

The following, which is also a form of lemon-juice practice, 
was a favorite preparation, viz. : — 

R. — Pulv. cit. acid, ^i ; 

Quin. di sulph. grs. xvi ; 
Morph. sulph. grs. ij ; 
Spt. vin gall. opt. Oij. 
Mix. 

For the mother, the dose was a tablespoonful in two or three 
tablespoonfuls of hot water, sweetened with loaf-sugar, three 
times a day, viz., at noon, evening, and bedtime ; for the infant, 
teaspoonful doses in the same way. Meanwhile the mother took 
freely of the best fresh beef, potato-soup highly seasoned with 
cayenne, &c. Whatever Dr. Knapp's theory may be worth, we 
think there is a good deal of hard sense in the practice. 



564 FLAXSEED TEA AND POULTICE. 

Lent Usitatissimi Semina. Flaxseed. Linseed. — This needs 
no description. We introduced it here to speak briefly of the 
articles commonly called flaxseed tea, flaxseed poultice, &c. The 
demulcent, emollient, and nutritive qualities are all familiar to 
practitioners. 

The first article named, viz., flaxseed tea, which is simply a 
decoction of the seeds, is often badly prepared, and therefore 
rejected, as it should be, by many who would otherwise readily 
take it. Instead of throwing the seeds into a vessel of water 
and boiling for a given time, they should be placed in a small 
linen, or muslin, or flannel bag, and be suspended in the fluid 
by means of a string. The vessel should be perfectly clean, 
and covered during the process. Two or three tablespoonfuls 
of seeds will suffice for a quart of water, and the latter should 
be made to boil at least twenty minutes. With this kind of 
care, instead of a ropy fluid you have a homogeneous, mucila- 
ginous liquid that does not offend the eye nor the taste. If a 
little lemon syrup or currant jelly, or even vinegar, be added so 
as to acidulate gently, the decoction will be still more palatable. 

The flaxseed tea is very useful in ordinary colds and in dis- 
orders of the bowels and kidneys, proving demulcent, emollient, 
and somewhat nutritive. It may be taken ad libitum ; but as it 
is liable to spoil in a warm place, it should be prepared in small 
quantities at a time. 

The poultice is exceedingly soothing by reason of its soft, 
emollient quality. It is prepared from the seeds and also from 
the meal, the latter being preferable because it avoids lumps and 
uneven aspects. Some add the meal to a common bread and 
milk poultice, while others make the poultice entirely of ground 
flaxseed. This is boiled in water or milk to a proper consistence, 
and sweet oil or lard is added to increase the emollient quality. 
It should be applied twice a day. 

The flaxseed oil is sometimes employed alone or with kindred 
articles, as an emollient injection. The decoction is used in the 
same way, and both are soothing to the lower bowels, and often 
act through them on the bladder and other parts very bene- 
ficially. 

The oil is likewise added to fresh lime-water to form the well- 
known lime liniment, an excellent application for hums and 
scalds. The two should be mixed until a soapy compound is 
obtained, the bottle being frequently shaken during the process. 

Liniments. — These are often very serviceable as external 
means of affording relief. They are usually compounded of 
oleaginous matters with some other more medicinal agents, the 
whole mixture having a decidedly oily aspect. We give a few 
formulae that may be useful : — 






FORMULA FOR LINIMENTS — POPLAR. 



565 



Iodine Liniment. 

R. — Liniment saponis, ^i; 

lodin. grs. x. 
Mix. 

Antispasmodic Liniment. 

R.— 01. olivar. 

01. terebinth. 

Aq. ammon. 

Tinct. opii, 

Linim. sapon. aa ^ss. 
Mix. 

Turpentine Liniments. 

1. R. — Aq. ammonise, ^ss: 

01. olivar. 

01. terebinth, aa ^i. 
Mix. 

2. R. — Aq. ammon. ^i; 

01. olivar. ^ij ; 
Spt. camph. ^iss ; 
Spt. terebinth, ^iij ; 
Sapon. dur. !fss ; 
01. cajeput. ^i. 
Mix. 

3. R.— Pulv. opii, ^i; 

Pulv. camph. ^ij ; 
Aq. ammon. ^iv ; 
Spt. terebinth, ^viij ; 
Sapon. dur. ^iv ; 
Alcohol, Ibiss. 



Mix. 

4. R._S p t. terebinth, ^i; 
Tinct. canthar. ^ss; 
Aq. ammon. gij ; 
Sapon. dur. ^i ; 
01. cajeput. ^ss. 
Mix. 

Anodyne Liniment. 
1. R.—Ol. olivar. ^i; 



Aq. ammon. ^ss; 
Morph. sulph. grs. x. 



Mix. 



2. R. — Liniment sapon. ^i; 
Aq. ammon. ^ss ; 
Tinct. opii, ^ss ; 
01. caryoph. gi. 
Mix. 

Compound Soap Liniment. 

R. — Sapon. Castil. gi; 
Alcohol, ^vi ; 
Camphorse, ^ss. 
Dissolve these by gentle heat ; then 
add 

01. rosmar. ^iv; 
01. cajeput. ^i; 
Aq. ammon. £ij. 
Mix. 

Tobacco Liniment. 

R.— Tabac. fol. -fi; 
Adip. suill. Ibi. 
Melt, and simmer for fifteen minutes, 
and strain through flannel. 

Rubefacient Liniment. 

R. — 01. olivar. 

Spt. ammon. aa ^ij ; 

Camphorae, £ss ; 

Sinap. sem. pulv. 

Cayenne Afric. aa gi ; 

Alcohol, ^ij. 
Mix. 

Compound Camphor Liniment. 

R. — Pulv. opii, ^ij ; 

Camphorse, 

Succini, aa gi ; 

Spt. ammon. ^vi. 
Mix. 

Pustulating IAniment. 

R. — 01. croton tigl. ^ss; 

Antimon. tart, ^ij ; 

01. olivar. ^i. 
Mix. Rub smartly into the skin, 
guarding carefully the eyes. 



Liriodendron Tuliplfera. American Poplar. — It is named 
here because it is a native substitute for the Peruvian bark. It 
is one of our most stately, elegant forest trees, growing to the 
height of eighty and a hundred feet. It flowers early in May, 
and when in full bloom presents a very inviting aspect. 

The bark of this tree has been the subject of several inaugu- 
ral theses, the best of which was furnished by the late Professor 
Emmet, of the University of Virginia, who succeeded in obtain- 



566 LIVERWORT. 

ing a peculiar proximate principle to which he gave the name 
Liriodendrine. 

The powder of the bark is a decided tonic, proving also occa- 
sionally diaphoretic and diuretic. It has been combined with 
carbonate of iron for making the tonic powders. Under its use 
the tone of the stomach is invigorated, the appetite improved. 
From thirty to ninety grains may be given to an adult several 
times a day, in any kind of syrup. A tincture and infusion have 
also been employed. Sometimes it excited some intestinal dis- 
turbance, but that is easily controlled. When neither Peruvian 
bark nor sulphate of quinine can be procured, a pretty fair sub- 
stitute will be found in a mixture of this bark with dogwood and 
snakeroot. 

Liverwort. Marcliantia Poly morphia. — I introduce this 
article not because of .any personal acquaintance with it, but 
simply on the authority of Dr. Shortt, of Edinburgh. 

The plant grows in moist, shady places, on the banks of rivers, 
and is met with at all seasons, though found to be most vigorous 
near the end of autumn. It has a penetrating and mildly-pungent 
taste, with a good deal of bitterness. It was formerly deemed an 
excellent medicine for liver disease, and hence its name. It has 
been called aperient, resolvent, &c. &c, and certainly merits the 
title of diuretic. 

Dr. S. called public attention to its powers as an external re- 
medy, in a paper first published in the Edinburgh Medical and 
Surgical Journal, affirming that he has for a long time employed 
it, in the shape of poultice, in the treatment of dropsies. He 
directs two large handfuls of the leaves, carefully picked so as 
to have the most mature, and these put in a pot containing boiling 
water. The vessel, covered, is to be placed on a gentle fire to 
simmer for several hours, fresh water being added sufficient to 
keep the leaves covered. The mass is then to be beaten into a 
pulp, and flaxseed-meal to be stirred in, so as to form a poultice. 
This, while pretty hot, is spread on flannel and applied to the 
abdomen or legs, according to the location of the dropsy ; a 
bandage is to be employed to keep the poultice in place, and this 
application is repeated once in twelve hours, until the water is 
drained off; or, if this result does not come at once, continue for 
three or four days, to see what will result. 

The poultice almost always excites a copious perspiration and 
a free discharge by the kidneys. In persons of feeble health, 
feelings of sinking and exhaustion may come on as a consequence 
of the evacuation ; but these can be controlled by teaspoonful 
doses of sweet spirits of nitre, or Volatile aromatic spirit in half 
that quantity. 

The poultice was exclusively relied on by Dr. Shortt to re- 



LOBELIA INFLATA. 567 

move tlie effusion, so far as medicine was concerned. The effects 
were augmented by the free use of warm diluent drinks, by thin 
chicken broth, &c. &c. ; warm clothing and a recumbent posture 
being also enjoined as long as the application was continued. 

The treatment is affirmed to have succeeded best when other 
means had been tried, fairly, in vain. Some of the reported 
cases are quite remarkable. A female, aged forty^four, quite 
emaciated by the repeated use of mercurials, acetate of potash, 
and other diuretics, submitted to the use of the liverwort poultice. 
In nine days it effected the discharge of seventy-four pounds and 
a half of urine, being an average of eight pounds per day. In 
this case the poultice was laid on the abdomen, for the cure of 
ascites. The patient being a good deal exhausted, the remedy 
was laid aside. In a few days it was resumed, and kept on for 
eighteen days, in which time one hundred and ninety-six pounds 
of urine came away, being an average of eleven pounds per day. 
In three months afterward the patient was entirely well, and that, 
too, without a resort to any other medicine. 

Dr. Stevenson, a British surgeon, was requested by Dr. Shortt 
to give the remedy a fair trial in India. He did so, and with 
great success. 

Lobelia Inelata. Inolian Tobacco. — Savages and empirics 
have been familiar with this article from time immemorial, but its 
first introduction into regular practice was by Dr. Cutter, a New 
England clergyman. The steam-doctors claim it as one of their 
medicines, although its virtues were well known prior to the birth 
of the first patron of the steam system. 

It is a very common weed on roadsides and in neglected fields, 
in most parts of the United States. In the West, almost every 
boy is familiar with it as a plant, and not less so with its high 
repute as a remedy in his own neighborhood. It is a biennial 
plant, varying in height from one to two feet, with bluish-looking 
flowers and inflated capsules. When bruised or broken, a copious, 
milky juice flows out. Every portion of the plant is medicinal, 
and the proper time for gathering is near the close of summer. 
When the fresh leaf is chewed, it gives a heating and pungent 
sensation, somewhat like that of green tobacco. If the leaf be 
held in the mouth for half an hour, or even a few minutes, it in- 
duces giddiness, pain of the head, sickness and vomiting. It 
is emetic, diaphoretic, expectorant, antispasmodic, sedative, and 
poisonous. 

From ten to twenty grains of the powdered leaves, or of the 
seeds, will act as an emetic in an adult. If given as such when 
the system is too much excited, the article displays a cumulative 
quality, and kills by the terrible violence of the vomiting when 
it does ensue, or by its fatally sedative agency. A case of this 



568 USES OF LOBELIA. 

kind happened in the West, in 1832, a few months before the 
Asiatic cholera made its appearance. A well-known printer, in 
a very extensive newspaper establishment, was taken ill at mid- 
night, after returning from his lodge, where he had passed the 
evening in apparent good health. A steam-doctor plied him with 
lobelia, close after dose, until the man was killed by the physic. 
The treatment occupied but a few hours, and the event produced 
quite an uproar among the comrades and friends of the deceased. 
It was resolved to have a public post-mortem examination, which 
was made in the presence of a large crowd of citizens. Scarce 
a trace of disease could be found in the stomach or bowels ; cer- 
tainly nothing to account for the result. The appearances were 
precisely like those seen after death from Asiatic cholera ; and 
if this case had occurred three months later, it would have been 
chronicled with the daily death-reports of that disease. The 
rapidity of the case to a fatal issue was so great, and the vio- 
lence of the action so intense, as to give no opportunity for the 
development of obvious lesion. The like has been seen fre- 
quently after sudden death preceded by intense suffering. 

It is quite obvious that a medicine of so much power ought not 
to be employed by any but the most judicious physicians, and 
should never be exhibited by ignorant men. 

The nauseant, and, consequently, expectorant action of small 
doses is generally safe, and often salutary. Hence its adapted- 
ness to ordinary colds and coughs, in which the lobelia is so fre- 
quently employed in domestic practice. 

For these ends the tincture is sometimes preferable. I have 
often used a mixture of equal parts of this tincture and the 
tincture of sanguinaria Canadensis, with very good effect, for the 
relief of chronic bronchitis and catarrhal affections. A tea- 
spoonful of the mixture, two or three times a day, will be a suit- 
able adult dose ; and it should be gradually augmented until it 
induces slight nausea. 

The simple tincture is made by digesting four ounces of the 
seeds or leaves in a quart of alcohol for two weeks. Of the 
filtered liquor, the adult dose is half an ounce as an emetic, and 
from one to two drachms as an antispasmodic. Dr. Cartwright, 
of Mississippi, prefers a saturated tincture, made by filling a 
bottle loosely with the leaves or seeds, and adding of the 
strongest brandy as much as the bottle will contain. Of this, 
which makes a very efficient medicine, he gives a teaspoonful 
every two or three hours, generally in combination with syrup of 
squill. Dr. Cartwright addressed a letter to one of the editors 
of the Medico-Chirurgical Hevieiv some years ago, in which he 
says, " Lobelia is for inflammations and congestions of the mu- 
cous coat of the bronchial tubes just what the lancet and anti- 



USES OF LOBELIA. 569 

monials are for inflammation of the serous membranes of the 
thoracic viscera." This is very high encomium, and plainly 
teaches the sedative property of lobelia. 

The tincture, combined with oxymel of squill, has been fre- 
quently employed as an expectorant for old persons and children. 
The same combination has been useful also in asthmatic disease 
with accompanying spasmodic action. 

The tincture of lobelia has been much employed by patients 
who have not sought medical advice to direct them. They have 
used it in chronic bronchitis and paroxysmal asthma, and felt 
sure of deriving benefit from it. It often induces nausea and 
sense of depression for half an hour following each dose, yet the 
appetite and digestion seem to be really improved in the end. 
When the nausea is insufferable, three drops of dilute hydro- 
cyanic acid will check it. — Lon. Medical Times, Nov. 12, 1853. 

The saturated tincture of lobelia, frequently applied by muslin 
cloth saturated with it, is affirmed to be more satisfactory, as an 
application in erysipelas, than iodine, by Dr. Livezey, of Boston. 
Of course the usual internal means for rectifying the digestive 
organs must be fully attended to. — Boston Medical Journal. 

An infusion of the leaves or seeds in hot water has often been 
substituted for the tincture, and will answer quite as well. Three 
or four ounces may be added to a quart of boiling water and 
allowed to stand until cold. The filtered liquor, given in table- 
spoon doses, will soon vomit an adult. An interval of twenty 
minutes between the doses is desirable. The second dose will 
generally operate. 

To illustrate the folly of quackery in reference to articles of 
Materia Medica, I give below an extract from a long statement 
of reasons for becoming a convert to the Thompsonian or steam 
system of practice. It is taken from a periodical conducted by 
a professor in a Western school. The narrator tells the public 
that he was nearly dead of pulmonary consumption, and that 
lobelia cured him. The extract runs thus: — "The last day of 
breaking up my fallow unraveled the whole secret. A near 
neighbor of mine, a real Thompsonian, who had noticed my great 
increase of health and strength, happened to come into the field 
where I was ploughing. I stopped my team, and a conversation 
commenced on the subject of my recovery, when the gentleman, 
looking over the ground, not yet ploughed, for some minutes, 
turned to me and asked if all the field had been covered with the 
same vegetation then growing there ? I answered that it had. 
Ah ! then, said he, you are now compelled to become a Thomp- 
sonian in spite of yourself, with all your prejudices to the con- 
trary notwithstanding. I asked him, with some surprise, why he 
made that assertion. Why, do you not know that that weed is 

37 



570 LOCAL BLEEDING — LOZENGES. 

lobelia? said he. I replied that I did not know it. He then told 
me it was what had effected my cure, and recommended me to 
leave the balance of my field, about half an acre, being well covered 
with this valuable (or, rather, invaluable) weed. My friend then 
recommended me to walk over this piece of ground every day, 
and occasionally to lie down and roll about over it. I did so until 
it became time to expect frost ; and, for fear my cure was not 
perfected, I determined not to lose the benefit of this during the 
winter. I therefore gathered enough of it to fill a bedtick, on 
which myself and wife slept all the fall and winter, she not being 
in very good health. And now, to the astonishment of every 
one who knows us, we are both in first-rate health and spirits." 

Local Bleeding. — This is effected by the use of cups and a 
scarificator, or by leeches. The latter are always to be preferred 
when we desire to deplete from the mouth, the eyelids, the lips, 
the ears, the axillse, the organs of generation, the anus, &c, 
where it is impossible to apply cups. But we are often much 
assisted in our therapeutic intentions by the use of cups, and both 
modes may be alike efficient in the work of local depletion. It 
must never be forgotten that the local method is never so proper 
before as after general depletion in a plethoric, febrile subject. 
We must first lessen the quantity and momentum of the blood in 
the vessels by bleeding from the arm, or we shall fail to give relief 
to a local inflammation by the use of cups or leeches." 

Lozenges. Trochisci, from a Greek word meaning a wheel. — 
Lozenges are flat and round, like a wheel. They are compounded 
of powders and other matters blended with glutinous substances, 
made into cakes, and dried. This form suits well for some 
patients ; and as the lozenge generally contains some aromatic, 
it is, on the whole, an agreeable mode of exhibition. 

When the mass for lozenges is so glutinous as to stick to the 
fingers in making it up, the hands may be anointed with some 
sweet or aromatic oil, or sprinkled with starch or liquorice pow- 
der, or wheat flour. In order to dry the lozenges completely, 
place them on an inverted sieve, in a shady, airy place, and turn 
them several times in the day. They are best preserved in glass 
or glazed earthen jars'. 

We have more than once taken lozenges for the relief of a cold, 
and have been obviously benefited. The smallness of the dose 
in each is no objection, because they may be taken repeatedly 
and without injury. 

We give the formulae for a few of these compounds : — 

Tolu Lozenges. — Take two pounds of white sugar, three ounces of cream of 
tartar, an ounce of starch, half an ounce of tincture of tolu, and as much 
mucilage of gum tragacanth as may be needful to make a proper mass. Divide 
into parts, each weighing six grains. 



MAGNESIA. 571 

Ipecacuanha Lozenges. — Take of powder of ipecacuanha half an ounce, of 
sugar fourteen ounces, four ounces of arrow-root, and as much mucilage of gum 
Arabic or gum tragacanth as may be needful. Mix, and divide into masses of 
ten grains each. These and the tolu lozenges are expectorant. 

Lozenges of Liquorice and Opium. — Take of powder of opium half an ounce, 
liquorice ball, sugar, gum Arabic in powder, of each ten ounces, oil of anise two 
drachms. Mix, and add water enough to form a mass. Divide into lozenges 
of six grains. They are demulcent and anodyne. 

Mint Lozenges. — Take of oil of peppermint a drachm, sugar in fine powder a 
pound, mucilage enough to make a mass. Divide into parts weighing ten grains 
each. These are carminative. 

Magnesia Lozenges. — Take of calcined magnesia four ounces, sugar a pound, 
nutmeg a drachm. Reduce to a fine powder, and make into mass with mucilage. 
Make into lozenges each weighing ten grains. These are antacid. 

Magxesia. — This was formerly employed as a generic term, 
to denote any substance that had the power to attract something 
from the air, as moisture, and was taken originally from magnes, 
a loadstone. 

Magnesia is a white, earthy-looking substance, having a me- 
tallic base, and being, in fact, an oxide of magnesium. It im- 
parts a sensation of roughness to the fingers, is insipid, inodor- 
ous, infusible, attracts water feebly, and yields it again at a red 
heat. 

It is insoluble in water, and yet augments the solubility of 
camphor in that fluid. It is known in the shops as pure mag- 
nesia, magnesia usta, calcinata, burnt or calcined magnesia. 
The action of a strong heat expels the carbonic acid from the 
carbonate of magnesia, and the pure earthy-looking matter is 
left, on the same principle that pure or quicklime is obtained. 

With nitric and muriatic acids, magnesia forms salts that are 
soluble in alcohol and quite deliquescent. These are not em- 
ployed in practice. With sulphuric acid, it forms a salt very 
soluble in water, and much in use in the profession. 

The alkalies precipitate magnesia from its salts. But if car- 
bonate of ammonia be added to a solution of a salt of magnesia, 
there is no precipitate until phosphate of soda is added, and then 
a copious white powder falls, which is the phosphate of magnesia 
and ammonia. On this principle we detect the presence of 
magnesia in mineral and other waters. 

If pure magnesia be rubbed with calomel and a little water, 
a grayish tinge runs through the mass, supposed to depend on 
the formation of a little protoxide of mercury. Whether this 
be the fact or no, it is best to mix the usual dose of calomel and 
magnesia with syrup, and not with water. This avoids the show 
of a change of color. 

In all cases of excessive flatulence with acidity of stomach, 



572 CARBONATE OF MAGNESIA. 

the pure or calcined magnesia is preferable to the carbonate. 
The latter increases the difficulty, so far as flatulence is con- 
cerned, by the evolution of carbonic acid gas by the action of 
the gastric acid. The magnesia neutralizes the acid, forming a 
salt that has some cathartic power, and passes off by the bowels. 
The usual adult dose of the calcined magnesia is a teaspoonful, 
to be repeated if necessary. It may be taken in water or in 
milk. Some prefer the latter, rubbing well together and strain- 
ing through fine gauze. The gritty particles are thus detached, 
and no injury done to the medicinal property of the dose. 

It is well to remember that the frequent use of magnesia or 
its carbonate may be attended with accumulations in the ali- 
mentary canal, which will impact it, and sometimes destroy life. 
To prevent this accident, a mild yet sufficiently potent cathartic 
should be occasionally interposed for the purpose of clearing out 
the bowels. 

The physician is liable to imposition in respect of this very 
simple medicine. At one time there were but two persons in 
Europe whose patent calcined magnesia came to this country, 
and no one prepared it at home. Now it is probable that twenty 
establishments have their pure article in the market, and the 
result is an actual increase in the quantity of defective material. 
It is therefore important to have some convenient method for 
determining the purity of calcined magnesia. If really destitute 
of carbonic acid, as it should be, there will be no effervescence 
on the addition of any acid stronger than the carbonic ; even 
pure acetic acid or strong vinegar may be sufficient. Hydro- 
chloric and sulphuric acid will certainly and instantly decompose 
the compound if it be a carbonate and not the pure base. 

Carbonate of magnesia differs from the article last spoken of 
in the fact of carbonic acid being part of its composition. It 
can be readily obtained by the double decomposition of sulphate 
or muriate of magnesia, and carbonate of potash or soda in solu- 
tion. One hundred and forty-four grains of crystallized carbon- 
ate of soda will decompose one hundred and twenty of crystal- 
lized sulphate of magnesia. These salts should be separately 
dissolved in six times their weight of boiling water ; the mixture 
of the two being afterward boiled for the space of ten minutes, 
and the copious precipitate well washed with pure water on a 
clean linen filter, so as to carry off any undecomposed sulphate. 

The lump or square magnesia, kept in drug stores, is the car- 
bonate, and differs not at all from the powder, save in form. 

The medicinal uses of the pure or calcined magnesia and the 
carbonate are very much alike. Both have been long employed 
in the treatment — and prevention, too — of calculous deposits in 
the shape of urinary sediment, consisting of uric acid, or red 



CARBONATE OF MAGNESIA. 573 

sand, as it has been called. The continuous action of this medi- 
cine, either directly as a chemical agent or in virtue of its power 
to transform the tissues, has frequently caused a total disappear- 
ance of the peculiar color and deposit referred to. Given in 
doses of from twenty to sixty grains three times a day, or even 
once a day, it certainly does induce the result named; although 
I am of opinion that a wiser course is to employ as substitutes 
lime-water, soda, and potash, occasionally recurring after a time 
to the magnesia. All act on the same principle, but each with 
some peculiarity; and each will act the better for being laid 
aside for a few days. Whether these articles operate primarily 
on the stomach, and secondarily on the kidneys, or not, is imma- 
terial; we cannot certainly determine the question, nor would it 
help us much if we could. That the action is in great part 
chemical, appears from the well-ascertained fact that in all cases 
of urinary and calculous disease that are benefited by magnesia 
and kindred articles, the acids do harm, and vice versa. The 
magnesia preparations not only appear to neutralize the acid, 
but also to control the acid diathesis. 

It will often happen that carbonate of magnesia alone will fail 
to correct an acid and nauseated stomach when the object will 
be gained by adding lime-water. This is one of the numerous 
illustrations of desirable modification, as the result of combina- 
tion. A teaspoonful of the carbonate in a wineglass half full of 
lime-water is an admirable mixture for the purpose named, and 
is most effective if taken half an hour before a meal. 

We may also add the carbonate to aromatic waters and bitter 
infusions advantageously. Half a drachm in an ounce of com- 
pound infusion of gentian, and a few drops of oil of cinnamon, 
or a tablespoonful of cinnamon tea, will make a very good mix- 
ture for persons who have little appetite and some acidity of 
stomach. 

The well-known patent medicine, Daily's carminative, owes 
its good properties chiefly to magnesia. A little of the carbon- 
ate, or calcined article, rubbed with some oil of mint or cinnamon 
and water will answer quite as well. 

Magnesia is occasionally employed to excoriated surfaces, 
especially in infants. It is far better than many of the substi- 
tutes in use, because it is perfectly safe, while other articles are 
often pernicious. It acts as an absorbent of the moisture of the 
parts, and also by protecting them from the external air. 

In our boyhood we heard many a suggestion as to the sudden 
cure of warts, and once we were silly enough to test an old 
woman's hint as to the efficacy of a small bit of meat snatched, 
unseen, from a butcher's stall. This was rubbed over the warts, 
and they disappeared after a time, how long we do not remember. 



574 SULPHATE OF MAGNESIA. 

It is likely they went irrespective of the beef appliance. In a 
foreign journal for 1853, we find a notice of the removal of warts 
by the internal use of the common carbonate of magnesia, in tea- 
spoonful doses, night and morning. The excrescences dried up 
and fell off in fragments, not a trace being left at the end of 
three weeks. Many a young lady would gladly try this simple 
remedy. 

J5z-earbonate, or s^per-carbonate of magnesia is the carbonate 
with the addition of another equivalent of carbonic acid, which 
renders it quite soluble in water, while the simple carbonate is 
very sparingly so. A stream of carbonic acid gas passed freely 
into water in which magnesia is suspended at length produces 
the bi-salt. The solid bi-carbonate is readily soluble in fifty 
parts of cold water, while the carbonate requires twenty-five 
hundred parts. The aerated magnesian water, formerly kept 
in fountains in the apothecary shops, was a watery solution of 
this salt, a pint of which contained a drachm of magnesia, and 
therefore proved mildly aperient. It was a much more con- 
venient and agreeable method for the exhibition of magnesia 
than any of its predecessors. The sparkling quality of the water 
resembled it to the common soda water, and increased its agree- 
able qualities. It is to be regretted that this water has gone so 
generally into disuse. Many things are retained that do not 
possess a thousandth part of its real value. 

Both magnesia and its carbonate may be made more active 
as cathartics by the addition of two drachms of the sulphate of 
magnesia. When added to water and well mixed, the ingre- 
dients make the white dose, so popular in past years. The ob- 
vious whiteness of the mixture gave it the familiar name. It is 
well suited to cases of gastric acidity associated with habitual 
costiveness. 

The incompatibles of the carbonate and bi-carbonate are the 
acids and acidulous salts, neutral salts, alum, nitrate of silver, 
corrosive sublimate, sugar of lead, salts of copper, zinc, and iron. 

Sulphate of magnesia is the well-known Epsom salt. The 
old name, sal catharticum amarum, indicates its bitter quality. 
It retains its long-established character as the best of all our 
saline cathartics, and is in general use. We can make it by due 
admixture of diluted sulphuric acid and carbonate of magnesia, 
but that is not the usual mode. It is largely procured from the 
liquor that remains after the separation of common salt from 
sea-water. This liquor is boiled to separate a further portion of 
common salt, after which crystals of sulphate of magnesia are 
deposited, as the fluid cools, and these are purified by repeated 
solution and crystallization. But the salt is found in large quan- 
tities, not only in solution, but as a salt. The famous Epsom 



SULPHATE OF MAGNESIA. 575 

springs are composed almost exclusively of this salt. In several 
of the United States, the sulphate, nearly pure, is found in great 
quantities in caves. 

The close resemblance of this salt, as usually met with, and 
oxalic acid, has been the occasion of fatal mistakes. The latter 
has been dealt out for the purging salt, and death has been the 
consequence in repeated instances, of which the journals furnish 
abundant details. A very little care would prevent such blun- 
ders. The taste of the two is widely dissimilar, the one being 
intensely sour, the other unpleasantly bitter. This alone should 
suffice. The acid is wholly dissipated by a red heat, while the 
Epsom salt is unchanged. The latter has no effect on ink stains, 
which are soon obliterated by the former. 

The bitterness of the salt has made it objectionable, and we 
must when practicable accommodate the taste of our patients, 
especially while the infinitesimal practice rests on no other foun- 
dation. A very small quantity of pure tannin will effectually 
remove the bitter taste from Epsom salt; and on the same 
principle strong coffee will have the same effect, for it contains 
tannin. In place of dissolving a half-ounce or an ounce of the 
salt in water, let it be added to a cup half full of strong coffee. 
If any prefer the watery solution, let half a lemon be squeezed 
into the fluid mixture, and the bitter taste will be removed. 
Cremor tartar, and even strong vinegar, will have a like effect, 
though not to the same extent. We shall name presently a new 
mode of preparing this salt which entirely obviates the objec- 
tion made touching its bitterness. 

For some adults, a teaspoonful of the salt will generally suf- 
fice to procure gentle evacuations. Others may require a half- 
ounce or an ounce. Even in the largest dose named it is a safe 
medicine, and seldom procrastinates the purgation beyond three 
or four motions. A half-ounce or an ounce in a quart of thin 
gruel, milk warm, will be found a good expedient to keep up 
purgation for twelve hours, by exhibiting wineglass doses every 
hour or two. In cases of high arterial excitement this opera- 
tion proves very beneficial by its sedative agency. Here the 
effect is also hydragogue.* 

Dr. Henry, an Irish physician, some years ago published an 
article in the Medic o-Chirurgical Heview, setting forth a new 
plan for the exhibition of sulphate of magnesia; and having 
prepared and used the medicine according to his suggestions, I 

* It is well known that the action of a purgative dose of Epsom or Glauber's 
salt is materially aided by any condition that favors absorption. A small dose 
will suffice if given on an empty stomach before breakfast. And combination 
with a minute proportion of tartar emetic, which aids absorption by relaxing 
the vessels, will often powerfully assist the action of a cathartic. A quarter- 
grain will often meet this end. 



576 ACIDULATED EPSOM SALT. 

can speak of it in very favorable terms. His plan is thus : — 
Saturate any quantity of water with Epsom salt and filter 
through paper. To the clear solution add diluted sulphuric 
acid (an ounce and a half of acid to fourteen and a half of water) 
in the proportion of one ounce to every seven ounces of the solu- 
tion. The product is perfectly clear, and very slightly acidu- 
lous, but wholly void of bitterness. The dose is a tablespoonful 
in a wineglassful of water, which may be repeated if occasion 
require. Having taken the dose on several occasions, I can 
speak of its pleasant and effective qualities from personal know- 
ledge, and therefore advise practitioners to give it a trial. Each 
tablespoon dose contains two drachms of the salt and half a 
drachm of diluted sulphuric acid. 

Epsom salt is a good medicine to follow a dose of calomel, to 
accelerate the operation of the latter. If the calomel be given 
at bedtime and purging do not follow by the next morning, the 
usual dose of the salt may be administered. In this way it is 
often very useful in febrile diseases. 

We also add Epsom salt advantageously to infusion of senna, 
cremor tartar, and cardamon seeds. The French are partial to 
such combinations, and they are sometimes desirable; they se- 
cure thorough evacuations better than the salt alone. A drachm 
or two of common salt added to a watery solution of the same 
quantity of Epsom salt will give an energetic purgative draught, 
and yet free of any drastic quality. 

Epsom salt is one of the oldest medicines for the treatment 
of dysentery. Heberden gave a drachm of it with a grain of 
ipecacuanha, every six hours, in some simple aromatic water. 
The bloody discharges soon ceased, tenesmus vanished, and the 
patient promptly recovered. 

Citrate of magnesia has recently been highly praised as a 
cathartic by a French practitioner, whose formula and mode of 
administration were noticed in the American Journal of Medi- 
cal Sciences for October, 1847. The preparation was formed 
in order to obviate the bitterness of Epsom salt, and to furnish 
a mild, agreeable cathartic. The citrate is made by the double 
decomposition of sulphate of magnesia and citrate of soda, or 
by saturating citric acid with carbonate of magnesia. The mode 
of administration is thus:- — 

Take of citrate of magnesia, an ounce and a quarter ;* 
Citric acid, two ounces and a half; 
Simple syrup, four ounces; 
Essence of orange, two drachms; 
Carbonic acid water, nearly enough to fill 
a common soda-water bottle, (a pint.) 

* The original prescription is in grammes, which I have substituted as above. 



MAGNOLIA. 577 

The citrate and citric acid being reduced to fine powder, and 
with the syrup and essence placed in the bottle, are ready for 
the carbonated water. The happiest mode of filling it would be 
by means of a common fountain of Seltzer water. The bottle 
should be corked instantly, very tight. The citrate in the mix- 
ture is about equal to an ounce of Epsom salt, and the taste of 
the solution resembles that of lemonade. It causes no thirst, 
and very seldom any uneasiness in its cathartic action. 

I have never made a trial of this preparation, but cannot 
doubt that it will prove a happy substitute for Epsom salt and 
other magnesian compounds, and there may be patients to whose 
cases it would be peculiarly suited. 

Magnolia. — The U. S. Pharmacopoeia has selected as medi- 
cinal the glauca,\ acuminata, and tripetala, regarding them as 
possessed of like properties. They are alike also in the shining 
quality of their leaves and the exceedingly odorous nature of 
their flowers. My chief reason for introducing the magnolia 
here is because it may be usefully employed as a substitute for 
Peruvian bark. 

Dr. Eloyd, of Kentucky, and a graduate of the University of 
Pennsylvania, published an inaugural thesis on this article in 
1806, which may be seen in Dr. Caldwell's volumes of Select 
Theses. The naked fact that this paper was chosen as a part of 
the volumes referred to is some evidence of its value. Two 
varieties of the magnolia are especially noticed by Dr. F., viz., 
the acuminata and tripetala. The latter is most abundant in 
Kentucky, Tennessee, Alabama, Georgia, and the Carolinas, 
where it is called the umbrella-tree, because of a peculiar arrange- 
ment of the leaves. It is known also as the big-leaf, elk-ivood, 
Indian bark, &c. &c. It grows to the height of fifty, and even 
eighty feet, has a slender trunk, smooth bark, with very nume- 
rous branches and exceedingly large leaves ; some of these are 
eighteen inches long and eight wide. The flowers are large and 
white, having a very penetrating odor, which, though grateful 
to many persons, is offensive to others. The whole aspect of the 
tree is highly ornamental. 

The magnolia acuminata is most abundant in the Northern 
States, though found elsewhere. It is known by the names 
long-leaved mountain magnolia, cucumber tree, and cypress tree. 
The latter name is peculiar to the State of New York. The 
tree grows sixty feet high, and is nearly two feet in diameter; 
near to the summit it divides into several branches, and abounds 
in large, oblong, sharp-pointed leaves. The flowers have a bluish 
tinge, and are very large ; the seed-vessels resemble a cucumber, 

f The magnolia glauca is familiarly called sassafras swamp. 



578 USES OF THE MAGNOLIA. 

and hence one of the names. They have a fine crimson color 
when perfectly ripe, and, as they hang down, display the seed 
suspended by cotton fibres, and give to the whole a beautiful 
aspect. 

In the earliest periods of the aboriginal history of this country, 
the magnolias were employed in the various febrile diseases to 
which the natives were subject, and especially for the cure of 
intermittents. The details furnished by Dr. Floyd show quite 
conclusively that intermittents were frequently cured by the 
magnolia after cinchona had failed; and this fact alone proves 
the value of the article. It is stated that the bark always mani- 
fests a considerable degree of diaphoretic action, which favors its 
curative agency. It is less apt to disagree with the stomach 
and bowels and to induce fulness of the head than the Peruvian 
bark, and can be continued a longer time with more safety in 
all respects. In dyspepsia dependent on loss of tone in the 
stomach, magnolia was found to be a very useful medicine, acting 
evidently as a tonic and augmenting the digestive powers. 

Dr. Floyd made many experiments with the bark in powder, 
tincture, and infusion. The dose of the powder was from a half 
to a whole drachm three or four times a day, and may be con- 
veniently taken in syrup of lemon or ginger. An ounce added 
to a pint of boiling water will make a sufficiently strong infusion, 
of which a wineglassful may be taken six or eight times a day. 
The same quantity of the powder and a pint of brandy will give 
a tincture at the end of a week or ten days, which may be taken 
in tablespoon doses three times a day. The tincture and hot 
infusion have been employed in chronic rheumatism. 

Dr. Floyd speaks also of a resinous extract which he employed 
occasionally, though he appears to have regarded the powder as 
the best form of administration. 

On the authority of the same gentleman I am happy to add 
another feature in the history of magnolia that is really valuable 
and should be more generally known and appreciated. "In 
early life," says Dr. F., "I was much addicted to the use of 
tobacco, and especially to chewing the weed. I began to be 
seriously apprehensive that I should never get rid of the habit. 
Often have I thrown all my tobacco away while riding, resolving 
never to taste it again ; but I felt wretched without it. At last 
I tried the magnolia tripelata bark as a substitute, and filled my 
tobacco box with it cut into small pieces ; I found it quite agree- 
able, and soon became entirely satisfied with my new expedient, 
and thus got rid of a bad habit entirely." If Dr. F., who was 
born and reared in a tobacco-growing State, and accustomed to 
the weed from early boyhood, could so easily cure himself of a 
pernicious practice, who ought to despair? 



PROPERTIES OF MANGANESE. 579 

Manganese, the Oxide of. — It was observed that the work- 
men in the manganese mines of Macon, in France, uniformly 
escaped the itch, and that such persons as went to the mines as 
new hands, having the disease on them, were soon cured, merely 
by the circumstances of the place. Hence the fine powder of 
the oxide was resorted to as a remedy for the affection elsewhere. 
Six parts were rubbed with sixteen of lard to make an oint- 
ment the daily application of which for a short time effected a 
cure. As the fact was long ago stated in TillocJis Philosophical 
Magazine, vol. vii., it is wonderful that medical men have not 
paid more attention to it. The remedy is simple, cheap, and 
easily carried out. 

The sulphate of manganese was found rather accidentally to 
possess cathartic properties. Mr. Thompson, a surgeon of the 
Glasgow Infirmary, has employed it thus for several years, and 
finds it to act very much like Glauber and Epsom salt, and in 
pretty much the same dose. It is readily obtained by the action 
of diluted sulphuric acid on the common black oxide. 

M. Hannon has paid special attention recently to the medicinal 
powers of manganese, in consequence of the discovery of this 
metal in the blood by M. Millon, who presented a memoir on the 
subject to the Academic des Sciences, of Paris. Hannon has 
made experiments on himself and others, proving conclusively 
the power of manganese to improve the color of anaemic persons, 
just as iron has long been known to do. The result has been 
the development of important therapeutic resources, fully equal, 
and in some respects superior, to the ferruginous medicines so 
long known to the profession. In addition to the oxide and sul- 
phate, we now have the carbonate, malate, tartrate, phosphate, 
and iodide. 

It is stated as among the prominent advantages of manganese 
over iron that its preparations may be combined with all the 
vegetable tonics and astringents without any risk of chemical 
incompatibility. 

The carbonate is prepared by dissolving seventeen ounces of 
the pure sulphate and nineteen ounces of carbonate of soda in 
a sufficient quantity of water. Double decomposition ensues, and 
the precipitate is collected on a cloth saturated with honey. It 
is then mixed with ten ounces of honey, and rapidly evaporated 
to a proper consistence for making pills. The saccharine matter 
is necessary to prevent the proto-carbonate from being changed 
into per-carbonate of manganese. The dose is from four to ten 
pills, each of four grains, to be given daily to chlorotic girls who 
have not been benefited by iron. The further oxidation of the 
manganese is also prevented by adding fresh charcoal to the 



580 SALTS OF MANGANESE. 

pills. Two weeks suffice in most cases for the restoration of the 
natural color and the general vigor. 

The malate is procured by acting on the carbonate with malic 
acid. It is called an eligible preparation, the dose of which is 
from two to five grains in the form of pill. A syrup of the 
malate is made by combining an ounce of the malate and two 
drachms of the essence of lemon with sixteen ounces of simple 
syrup. An ounce of this syrup contains twenty-nine grains of 
the malate of manganese, so that the dose is about a teaspoonful. 
Pills are made by rubbing fifteen grains of the malate with as 
much powdered Peruvian bark, and enough honey to form the 
mass, which is to be divided into twenty pills. To form lozenges 
rub an ounce of the malate with eleven ounces of sugar and a 
sufficient quantity of mucilage of gum Arabic. Divide into 
lozenges of twelve grains each, and there will be a grain of malate 
of manganese in each lozenge. 

The tartrate is prepared in the same way as the malate, sub- 
stituting tartaric for malic acid. It may be employed for the 
preparation of syrup, pills, and lozenges, as the malate. But a 
very highly tonic syrup has been formed with it, as follows : — 

R.— Syrup tolu, g xvij ; 
Ext. rhatan. ^iiss ; 
Tart, uiangan. giiss. 

Mix well together, and give to an adult four or five teaspoonsfuls daily. 

Phosphate of manganese is best made by dropping a solution 
of phosphate of soda into a solution of sulphate of manganese. 
Collect the precipitate on paper, dry, and put away in close 
bottles. To make the pills, rub a drachm and a half with half a 
drachm of Peruvian bark, and a sufficient quantity of the syrup 
of catechu or other syrup to make a mass. Divide into pills of 
four grains each. The syrup is thus prepared : — 

R. — Phosph. mangan. gss ; 
Syrup tolu, giij ; 

" cinchon. ^v; 
Ess. limon. giss; 
Pulv. g. Arab, $i. 
Rub well together with as little delay as possible, and keep in a well-stop- 
pered bottle. The dose is a teaspoonful. 

To make lozenges, rub an ounce of the phosphate with twelve 
ounces of sugar and divide into masses of twelve grains each. 
Every lozenge should contain a grain of the phosphate. 

The iodide of manganese is prepared by digesting the recently- 
prepared carbonate with hydriodic acid, filtering and evaporating, 
at the same time preventing the access of air as far as practi- 
cable. Or it may be made by mixing an ounce of iodide of 
potassium with as much sulphate of manganese, both as dry as 



ARROW-ROOT. 581 

possible and in the state of powder. Then make it into pill- 
mass with honey, and divide into pills of fonr grains each. The 
dose is one pill daily, increasing gradually to six pills per day. 
Omit for eight days, and resume the dose as at first. The syrup 
of the iodide is made by adding concentrated hydriodic acid to 
a drachm of perfectly pure hydrated carbonate of manganese 
until complete solution is effected, then add seventeen ounces of 
the syrup of sarsaparilla. The dose is from two to six spoon- 
fuls daily. 

M. Hannon proposes, where iron alone has not succeeded, to 
combine the two metals, thus : — 

R. — Sulph. ferri. cryst. ^xiij; 

" mangan. pur. ^iiiss; 
Carb. sod. pur. gviiss ; 
Mellis, gx. 
Mix well together, adding syrup if needful to form a mass, which divide into 
pills of four grains each. 

The close is from two to ten pills daily. 

It is also suggested to prescribe the insoluble preparations 
first, as the carbonate, phosphate, and oxide, and afterward the 
more soluble, as the tartrate, malate, &c. &c. As these prepa- 
rations are more readily assimilated than those of iron, it is not 
necessary to exhibit them for so long a time as the preparations 
of iron. It is said that in the depraved state of the blood suc- 
ceeding intermittent fevers the salts of manganese are useful ; 
and it is held to be the most certain remedy for preventing a 
return of the attacks. Enlargement of the spleen is promptly 
reduced by the iodide with syrup of cinchona. (See Braiih- 
waites Retrospect, part xx.) 

Maranta Arukdinacea. Arrow-root. — The juice of this 
plant was employed by the Indians to extract the poison from 
parts wounded by poisoned arrows, and hence the name arrow- 
root. The substance sold under this appellation is a true fecula 
or starch, obtained from the roots a year old. These are well 
washed and beaten to a pulp in wooden mortars. The fibrous 
mass being thoroughly squeezed, a milky liquid passes, which 
after filtration deposits a white mass, which is the arrow-root. 
It is again washed with pure water, and dried in the sun. This 
is the genuine West India, Bermuda, or Jamaica arrow-root, 
and is an excellent article of diet for sick persons. 

What is called the East India arrow-root is seldom seen in 
this country, because of a plentiful supply of the article just 
spoken of, and also in consequence of a large quantity of potato 
arrow-root manufactured in this country and very much in use. 
The potato contains a large amount of fecula or starch, and 
yields it readily. It makes a fair article of diet, but is not so 



582 MATICO. 

good for delicate females nor for young children as the Bermuda 
arrow-root, which commands a much higher price. 

Arrow-root contains a good deal of nutriment suitable for the 
sick in a small bulk ; it is very bland and inoffensive. Boiled in 
water it is converted into a sort of jelly not unlike starch. A 
dessertspoonful will make a half-pint of the desired food. Rub 
it with a little water to make a paste, and add a half-pint of 
boiling water. Place the vessel on red-hot coals to boil for a few 
minutes, stirring briskly all the while. When cool add sugar and 
nutmeg, lemon or ginger syrup, as may be most agreeable. Some- 
times I have boiled a piece of cinnamon in the mixture, and thus 
pleasantly aromatized it. 

We can employ the arrow-root also as an injection, and its 
soothing agency is often valuable. We can make it the vehicle, 
too, of anodynes and other articles that we may not desire to 
exhibit by the mouth. 

Mastic. (See Pistacia Lentiscus.) 

Matica. Matieo. Piper Angustifolium. The leaves. — The 
first American notice of this article was by Dr. Ruschenberger, 
a surgeon in the United States Navy, who acquired a knowledge 
of it in 1834, while on a voyage on the Pacific coast. The full 
account can be seen in his published narrative. 

It would seem that the natives of Peru apply the term matieo 
to the leaves of several different vegetables, and hence the sub- 
ject is involved in some confusion. The appellation is probably 
given more generally, however, to the piper ang ustifolium, which 
is said to be not unlike cubebs in point of odor and taste. 

The principal therapeutic property is its astringencg, which 
does not depend entirely on tannin, for that has been detected in 
very minute quantity. We know that the presence of tannin is 
not essential to astringent properties, since we find these in alum 
and sugar of lead. The plant is certainly in high estimation 
with the natives of South America on account of its power to 
arrest hemorrhages and other profluvia ; hence it has been 
designated as a styptic. 

Mr. Home, of London, speaks in the highest terms of the 
styptic powers of matieo administered internally. He regards 
it as decidedly superior to all other astringents and styptics. 
He refers to his success in alarming hemorrhage from the nose, 
uterine hemorrhage, and bleeding after the extraction of teeth. 
(See Braithivaite, part xix. p. 144.) 

Dr. Lane, who furnished some account of it in the London 
Lancet for Oct. 1843, made a tincture and an infusion of the 
matieo leaves, or those of the piper angustifolium, which are 
said to be from three to six inches long and an inch wide. The 
infusion was made of an ounce of the leaves digested during two 






MAY APPLE. 583 

hours in a pint of boiling water, in a close-covered vessel, and 
then strained. To make the tincture, he put into a pint of 
brandy two and a half ounces of the leaves, macerating for the 
space of two weeks, and then filtering through paper. The dose 
of the infusion is from one to three ounces ; of the tincture, from 
one to three drachms. 

The infusion and tincture were also employed in the shape of 
injection, in leucorrhoea, menorrhagia, diabetes, &c. &c. 

May Apple. Mandrake. Podophyllum Peltatum. — The 
term May apple refers to the fruit of the plant known in all 
parts of the United States, very grateful to many persons, and 
as much disliked by others. Children reared in country places 
are very fond of it, and wander into woodlands to pluck it at 
the season of maturity. The plant rarely grows over eighteen 
inches high, and is remarkable for having but two long leaves, 
with a single flower, which is large, white, and rather fragrant. 
The fruit does not ripen in May, as its name imports, but early 
in August or late in July in some parts of the country, and not 
before September in others. It is nearly oval, of a pretty lemon 
hue, quite soft, and containing a thick mucilaginous pulp and a 
good deal of saccharine matter. If eaten freely it acts gently 
on the bowels ; but I never heard of any injurious effect, even 
when greedily consumed. 

Something has been said of a narcotic property in the leaves, 
but no fact in that relation has ever fallen under my notice, and 
I have had abundant opportunities for learning everything ap- 
pertaining to its history. 

The properties of the root vary as it is quite fresh or dry. If 
the juice be forced out of the young roots as they are taken 
from the ground, it will be found to possess active powers. Ap- 
plied to a common ulcer it is evidently eschar otic ; and I have 
been told that, swallowed in tablespoonful portions, it manifests 
symptoms of irritant poisoning. The dry root loses all this 
juicy matter, is about as thick as a goose-quill, of a blackish- 
brown exterior and a dirty white within, and is corrugated with 
knots here and there. It has a faint, unpleasant odor, some- 
what like that of ipecacuanha, and a bitterish, blended with a 
sort of sweetish taste. 

The term mandrake is very commonly given to the May 
apple in certain parts of the western country ; and the botanical 
stores in that region label the drawers containing the article 
with the one as often as with the other title. It is evidently a 
different article from the mandrake of Asia. 

The Indians were well acquainted with the cathartic properties 
of this plant long before the settlement of America by the whites ; 
and although they held it in high esteem as an anthelmintic, it is 



584 MEAT BISCUIT. 

altogether probable that this property depended entirely on its 
decidedly purgative action. No one now regards it as a vermi- 
fuge in any other sense. 

The root is among the most difficult vegetables to pulverize, or 
even to grind into a fine powder. This is the form generally 
preferred, and it is certainly by far the best substitute for jalap 
that we possess. Its action is very much like that of jalap, 
though a little more drastic when given alone. A very good 
modification is effected by the addition of cremor tartar, which 
makes it act more pleasantly, but giving it the property of a 
hydragogue. It is also modified advantageously by the addition 
of a few grains of calomel. Five or eight of the latter and 
twenty of May apple constitute an effective dose, and is best 
given in syrup. 

It is undoubtedly one of the best of our indigenous cathartics, 
and may well take the place of jalap in the shops of country 
practitioners. The Wyandotte Indians affirm that a careful 
roasting of the root takes away its griping quality; but this 
needs confirmation. We name an additional use of the plant 
by these Indians, viz., for the cure of deafness. They apply 
the fresh juice of the recent roots to the ear, on cotton or sponge. 

Mr. Barclay, in his notices of the Diseases of Syria and 
Arabia, in the N. Amer. Med.-Qhir. Rev. for September, details 
the poisonous effects of May apple root on a Scotch gentleman, 
who felt great anxiety to know whether it could be eaten with 
safety. The root, cut in slices, was boiled some ten hours, with- 
out being much softened. The water was made as black as ink 
by the process, owing to the action of tannin on the iron vessel. 
The slices were then fried in butter and served up at tea, and al- 
though the bitter taste prevented him from eating freely of it, 
yet he swallowed enough to render him very comatose. In bed, 
the narcotic action was decidedly augmented. In short, the man 
was evidently in a state of undeniable mental aberration, not 
very unlike that of delirium tremens. His pulse beat 140 in 
the minute, and he talked incessantly of the serious losses he 
had sustained by the fancied robbers with whom he had been bat- 
tling for hours. Being of very full habit, blood was drawn freely 
from the arm, dry cupping was applied to the spine, and he was 
freely purged with croton oil. The pupils continued to be 
dilated for many days, and it was nearly a week before he 
was well. 

Meat Biscuit. A new article of food.- — Mr. Gail Borden, 
Jr., of Galveston, Texas, has taken out a patent for a process 
combining in a cheap, convenient, and portable form all the 
nutritive portions of animal and farinaceous food. His inven- 
tion has the further advantages that all refuse, excrementitious 



MEAT BISCUIT. 585 

and superfluous matters are rejected ; and that the meat biscuit — 
for so Mr. Borden denominates his prepared article — can be pre- 
served fresh, without condiments or preservatives of any kind, 
for years, and in all climates ; care only being taken that it be 
kept dry. From several satisfactory trials, it is proved that Mr. 
Borden's process is equally adapted for combining any farina, 
flour or meal, with any of the meats of the animal kingdom used 
by man for food ; but he has hitherto confined himself to com- 
bining wheat flour with the flesh of neat cattle. 

Dr. Ashbel Smith, of Texas, well known in the political as 
well as in the medical world, thus describes the mode of prepar- 
ing, and the uses of this new article of food : — 

" The nutritive portions of the beef or other meat, immedi- 
ately on its being slaughtered, are by long boiling separated 
from the bones and fibrous and cartilaginous matters ; the water 
holding the nutritious matters in solution is evaporated till it 
becomes thick ; this is then made into a dough with firm wheaten 
flour, the dough rolled and cut into the form of biscuit, and 
then dried or baked in an oven at a moderate heat. The cooking, 
both of the flour and the animal food, is thus complete. The 
meat biscuit thus prepared have the appearance and firmness of 
the finest crackers or navy bread, being as dry, and breaking or 
pulverizing as readily as the most carefully-made table crackers. 
The article is preserved in the form of biscuit, or reduced to 
a coarse flour or meal. Tt is best kept in tin cases hermetically 
soldered up ; the exclusion of air is not important ; humidity 
alone is to be guarded against. I have seen some of the biscuit 
perfectly fresh and sound that have been hanging in sacks since 
last July in Mr. Borden's kitchen ; and it is to be borne in mind 
that in this climate articles contract moisture and moulder 
promptly unless kept dry by artificial heat. 

" For making soup of the meat biscuit, a batter is first made of 
the pulverized biscuit and cold water ; this is stirred into boiling 
water, the boiling is continued some ten or twenty minutes, salt, 
pepper, and other condiments are added to suit the taste, and the 
soup is ready for the table. I have eaten the soup several times ; 
it has the fresh, lively, clean, and thoroughly-done or cooked 
flavor that used to form the charm of the soups of the Rocher de 
Cancale. It is perfectly free from that vapid, unctuous, stale 
taste which characterizes all prepared soups I have hitherto tried 
at sea and elsewhere. Those chemical changes in food which, in 
common language, we denominate cooking, have been perfectly 
effected in Mr. Borden's biscuit by the long-continued boiling at 
first, and the subsequent baking or roasting. The soup prepared 
of it is thus ready to be absorbed into the system without loss, 

38 



586 MEL — MILK. 

and without tedious digestion in the alimentary canal, and is in 
the highest degree nutritious and invigorating. 

" I might here insist on the very great conveniences of Mr. 
B.'s meat biscuit arising from its dryness. For long voyages, it 
is best preserved in soldered tin cases or tight casks ; but it may 
be carried in sacks, suspended from one's saddle-bow, for weeks 
or months, over the prairies, or through the desert, without risk 
of spoiling, using care to keep it dry. 

"As the meat biscuit requires only ten to twenty minutes to 
be made into a hot, delicious soup, with the aid of fire and water 
only, its advantages for family use, for hospitals, at sea, and on 
long journeys over land, and wherever it is desirable to prepare 
food promptly, must be obvious." 

We have not had an opportunity of examining this article, but 
are disposed to think favorably of it as a valuable addition to our 
dietetics. 

Mel. — This is the well-known saccharine secretion from the 
honey-bee. As a matter of course honey will partake, more or 
less, of the properties of the plants whence the bees have 
gathered it, and hence we hear, occasionally, of poisonous honey. 
Diluted with water, honey soon undergoes vinous fermentation, 
and furnishes the pleasant beverage known as hydromel, or mead. 

Honey is demulcent, laxative, and expectorant. It is largely 
employed in gargles, and a constituent of several useful com- 
pounds. Recently, it has been spoken of as well suited to make 
pill masses when it is desirable to avoid hardness in the pills. 
It insures a comparatively soft pill, no matter how long the pills 
are on hand. 

Mentha. — The various kinds of mint are so well known and 
appreciated by medical men and others as to require no special 
notice here. In the form of infusion, poultice, or fomentation, 
or in the shape of oil and essence, the mints are justly regarded 
as good domestic remedies. They are carminative, stimulant, 
antispasmodic, and anthelmintic. Some persons regard them as 
emmenagogue also. 

Mesmerism. (See Electricity.) 

Milk. — In the article on Diet we have noticed the use of milk 
as a part of food. We have no doubt that sound, healthful milk 
is the best food for young children, and an excellent substitute 
for tea and coffee. In reference to adults not early accustomed 
to it, much will depend on peculiarity of constitution ; and indi- 
vidual circumstances must direct. 

We propose now to speak of milk as it is sometimes met with 
in various places. That it may be poisoned, even without crimi- 
nal design, is now well understood. The leaden milk-pans in use 
in Europe, and to some extent in this country, have often im- 



CAUSES OF MILK-SICKNESS. 587 

parted a deleterious quality to cream and consequently to butter. 
Many facts directly in point could be cited from the best au- 
thorities. 

Among the most fruitful sources of injury to milk is that 
agent, whatever it be, that gives rise to the disease so common 
to the western country, and called milk-sickness. This unex- 
plained source of mischief has perplexed not only the common 
people, but men of science, all over our own country, and not 
less the learned and unlearned of Europe. Hence the inaugu- 
ral dissertations that have been repeatedly written by candidates 
for graduation in medicine, the numerous essays of practicing 
physicians in various sections of the Union, and the elaborate dis- 
quisitions of eminent Germans and Frenchmen on this recondite 
question. And yet the darkness that envelops it is as dense as 
ever ; and we see not that science promises much to dissipate the 
gloom. 

Christison justly remarks, as others had done before, " That 
the milk of the cow, the ewe, and the goat may act like a viru- 
lent poison, although no mineral or other deleterious impregna- 
tion could be detected in it ; and these effects have been vaguely 
and variously ascribed to the animal having been diseased, or to 
its having been fed on acrid vegetables, which enter the milk 
without injuring the animal necessarily." And Orfila, to whom, 
in conjunction with Marc, was intrusted the examination of 
goat's milk that had proved poisonous to many persons, reported 
" That no mineral poison could be detected ; that none of the 
usual explanations were satisfactory; and that the poisonous 
change in the milk should he ascribed to new principles, formed 
or developed by a vital process." 

The conclusions just stated are, it may be, correct ; yet there 
is reason to believe that the poison may be derived from some 
kind of vegetable matter which could not be detected by chemi- 
cal tests. Dr. Westrumb, who wrote on the poison of cheese, 
held this opinion, and conjectured that the milk was poisoned by 
the cattle partaking of a species of spurge [Euphorbia esula) 
which, agreeably to Viridet, caused certain fields in the neighbor- 
hood of Embrim to be abandoned by the shepherds because it 
rendered the cow's milk useless. The same writer also observes 
" That the cows would not touch this plant so long as wholesome 
pasture was within their range." 

The symptoms in the cases already referred to as having 
occurred in France were those often seen in violent cholera. At 
Herford, Westphalia, where, according to Rust's Magazine for 
1828, a woman and her five children were poisoned with goat's 
buttermilk, sent to them by a charitable neighbor, the symptoms 
were violent pukings, dilated pupils, the eyelids half closed, pulse 



588 CAUSES OF MILK-SICKNESS. 

small, hard, and slow, epigastrium tumid, abdomen contracted, 
bowels unmoved. These, as will be seen, were not unlike the 
symptoms of milk-sickness in this country. Lukewarm water 
was given to increase the vomiting, after which two ounces of 
medicated soap, dissolved in a pint of water, with the addition of 
an ounce of almond syrup, were administered, and the bodies of 
the patients were washed with vinegar and spirits. In ten hours 
all the patients had recovered. 

A most careful examination of a portion of the buttermilk 
that had poisoned the family failed to detect any trace of mine- 
ral poison ; and the physician attributed the mischief to some 
narcotic herb, probably the ethusa cynapium, or fool's parsley. 

I have been at some pains to compare a thesis, written by Dr. 
Read, of Ohio, who graduated at the Medical College of Ohio 
in 1832, with another thesis written by Dr. Simpson, of Ken- 
tucky, who graduated at Transylvania University in 1839. Both 
treat of milk-sickness ; and although entirely unknowm to each 
other, their statements, professedly drawn from personal expe- 
rience and actual observation, very closely agree. Both assign 
the deleterious agent in milk to some vegetable consumed by the 
cows in new lands ; and they testify that the effect fails when the 
lands have long been under cultivation. This statement accords 
with the great mass of evidence throughout the world where the 
phenomena have been noticed. Dr. Simpson and others object to 
the miasmatic doctrine contended for by some in accounting for 
milk-sickness, because, as they allege, if cattle be placed on two 
distant fields on the same farm, the one subject to cultivation for 
several years, the other in a wild state and full of native vege- 
tation, those in the latter will be sickened, while those in the 
former will retain their accustomed health, although both be 
precisely alike as to the influence of the usual sources of mias- 
matic exhalations. 

In 1833, two citizens of Kentucky came to Cincinnati, anx- 
iously seeking .the cause of a terrible devastation among cattle 
and human beings in their neighborhood, which they supposed 
could be detected in the water of which the animals and others 
drank. They handed me a jug full of the water, which was per- 
fectly limpid, insipid, inodorous, and without sediment. The 
disease complained of was the milk-sickness, and the water was 
imagined to be poisoned with arsenic in some way or other. Yet 
it was not possible to detect any sort of poisonous matter ; in 
fact, the water was of the purest kind. I gave it as my opinion 
then, and still believe, that the milk had been deteriorated by 
some unknown and not discoverable agent belonging to the vege- 
table kingdom. When I say "not discoverable," I refer to the 



CAUSES OF MILK-SICKNESS. 589 

action of tests, for I fondly hope that the source of this poison 
is jet to be ascertained. 

I have never witnessed the disease called milk-sickness; but 
as it is most probably a form of g astro-enteritis, it should be 
treated as that disease is generally managed. In mild cases, 
such as those referred to above, in Rust's Magazine, a very sim- 
ple treatment, as there stated, will suffice. 

My own opinion of the source of this peculiar milk-sickness is 
that it depends on the same agency, modified, no doubt, that 
gives rise to autumnal fevers generally. This view has been 
strengthened by the perusal of Baron Larrey's description of a 
fatal epidemic among cattle, recorded in the first volume of his 
Memoirs, page 84, &c. I do not remember to have seen this 
paper referred to by any writer on milk-sickness, though I have 
not been able to read all that has been published on the subject. 
But I have no doubt that the disease described by Larrey, 
although somewhat changed in character by climate, was truly 
and essentially the same disease that we call milk-sickness for 
want of a better term. The specific poison that generated it we 
know not, because we are yet ignorant of the essential nature 
of the poison that gives birth to epidemic intermittents and re- 
mittents. 

" The disease was at its acme when I arrived at Udino, in 
1793. It assumed all the characters of an inflammatory an- 
thracia, or malignant fever. It commenced by a general heat, 
which was particularly observable in the horns, dryness of the 
nostrils, bristling of the hair, hardness of the skin, and obsti- 
nate constipation. The sick animal drooped its head, appeared 
agitated, the eyes became red and haggard. This fever pro- 
ceeded, from the commencement of the symptoms, with more or 
less rapidity, according to the age of the animal or its irrita- 
bility. 

"After this first stage the abdomen became inflated, the hair 
dry and stiff, and easily disengaged by the fingers ; the strength 
failed ; the ears became withered and pendent ; cutaneous perspi- 
ration ceased ; the breath grew fetid, respiration difficult ; the 
animal tottered, and if it fell had not power to rise. Sometimes, 
at this second period, the intestines relaxed spontaneously for 
the copious discharge of a black, fetid excrement. To this suc- 
ceeded an almost constant dysenteric flux of blackish, bloody 
matter, equally fetid ; the debility increased, and the animal 
died. Malignant tumors appeared sometimes on the cows, near 
the udder. 

1 '- Post-mortem examination showed the stomach to be filled 
with undigested vegetable matters. The mucous membrane of 
the stomach and intestines was inflamed, and in some places 



590 MILK-SICKNESS IN EUROPE. 

gangrenous. The pituitary membrane also partook of the in- 
flammation. The intestines were inflated, and the omentum 
decayed. 

"At the third stage the disease was highly contagious: in 
fact, all the cattle in the stable with an infected animal took it 
and died. The constant communication between cow-herds and 
shepherds of different farms, between domestic animals, such as 
dogs, cats, &c, propagated the disease from stable to stable, 
from village to village, and I have observed on some farms the 
oxen, cows, sheep, and fowls all infected. 

" The whole province of Frioul had been thus infected in a 
short space of time by this disease. Even the inhabitants of 
the places where it was most violent were subject to its malignant 
influence." 

Larrey notices the influence of " sulphuro-ferruginous springs," 
in a certain neighborhood, in securing animals from the disease, 
and quotes authorities of a like nature. 

" The disease," says he, " was first observed in the black cattle 
which were put into this swampy pasturage, and soon extended 
to the interior of Frioul, while it disappeared along the borders 
of the Adriatic, where the sea-breezes conveyed vapors which 
held mineral substances in solution. The mortality was ' very 
great, and the disease began to affect even the inhabitants them- 
selves." 

Larrey bled in this disease at once, if symptoms of plethora 
were present. After bleeding, measures were adopted to over- 
come the costiveness, which always demanded attention. Emol- 
lient and camphorated clysters were given ; cooling mucilaginous 
and nitrated drinks ; the whole body was bathed with warm water 
and vinegar, and then covered with a woolen cloth. The horns 
of the animal were also bored, to give vent to fluid matter. 
Free evacuation of the bowels about the third day and cutaneous 
perspiration were good signs. In all cases in which the crisis 
was clearly marked before the ninth day, the animal was saved. 
If the symptoms were not calmed before this period, it died. To 
keep up the perspiration, and also to purge moderately, strong 
decoctions of serpentaria Virginiana, absinthium, &c. were given, 
adding at intervals a few grains of jalap. When all the symp- 
toms had disappeared, parboiled corn or wheat flour softened 
with warm water, a little salt being added, were found to be the 
best nutriment. 

We may remark that this fatal disease has been by some sup- 
posed to be peculiar to the United States, although we have 
shown above that this is not the fact. And although Larrey, 
probably from the occupancy of his time by his duties as military 



MILK-SICKNESS OF LARGE CITIES. 591 

surgeon, did not note down the effects produced by the milk of 
the oows on human beings, yet we think he has stated enough 
to make it very probable that the disease he describes was milk- 
sickness. The idea of the spreading of the disease from one 
animal to another is intimated, yet all this may have been the 
result of exposure to the common cause, whatever that may have 
been. 

The rapidly fatal nature of the disease set up in the West and 
elsewhere by deteriorated milk excites terrible consternation in 
comparatively small neighborhoods ; and we do not wonder that 
it is so. But is the evil less real in all our large cities, where 
thousands of infants and young children perish every year from 
the same cause ? Who does not know that milk has ever consti- 
tuted a very large part of the diet of young children in all coun- 
tries ? And who can doubt that when pure it is among the most 
suitable articles of nutriment? Yet this necessary item is 
poisoned by the murderous cupidity of men who often pass for 
respectable members of society. 

We desire to attract the attention of medical men to this in- 
teresting subject, since we believe most unhesitatingly that 
many of the diseases of childhood and even of riper years may 
be traced to the pernicious action on the stomach and bowels 
of a daily article of food, rendered slowly poisonous by fraud, 
neglect, want of cleanliness, and various other deleterious 
agencies. 

While, therefore, we talk of the milk-sickness of the far 
West, it is important to keep in mind the notorious fact that a 
far more extensive milk-sickness prevails in all our large cities, 
where every sort of fraud is perpetrated to render the milk of the 
cow a source of poison to the community, and especially to the 
infantile race. 

No man will be at a loss to comprehend the force of our re- 
marks who will read attentively the essay of Hartley, on milk, 
published in New York in 1842. The facts therein set forth have 
never been controverted, because it was not possible to refute 
them. They prove with the certainty of a mathematical demon- 
stration the position here announced, viz., that cow's milk is 
poisoned by wholesale in our large cities, and that the common 
use of such an article of food is the grand secret of a very large 
portion of the infant mortality of our country. 

Mixtures. — The foreign books abound with articles of this 
description, which are neither tinctures, infusions, nor decoc- 
tions. Some of them are more available than other forms of 
medicinal composition, and we subjoin several that will probably 
be found valuable. They were formerly called Juleps. 



592 



MIXTURES. 



Alkaline Anodyne Mixture. 

R. — Sod. bi-carb. Qi; 

Tinct. hyosciam, gss; 
Tinct. cardam. comp. ^i. 
Mix for a draught. This may be re- 



Anodyne Mixture. 

R. — Aq. menth. 5vi; 
Nit. potass, j^ij; 
Spt. nit. dulc. gij; 
Sulph. morph. grs. iv; 
Ext. taraxaci. 
Syr. limonis, aa gij. 
Mix, and take a tablespoonful for a 
dose. 

Stomachic Mixture. 



R. 



Mix. 



-Magnesia, gi; 
Potass, nit. giss; 
Quin. sulph. grs. v; 
Syr. zingiber, ^ij; 
Aquas lavend. ^iss. 
Dose, a tablespoonful just be- 
fore dinner. 

Compound Camphor Mixture. 

R. — Camphor, ^i, 

reduced to powder, with 

Alcohol, TtVvi; 

Moschi, gss; 

Ammon. aromat. spt. gij; 

Spr. limonis, t ^ss; 

Muc. g. Arab. t ^iv. 
Mix well. The dose is a tablespoon- 
ful, to be repeated as circumstances 
require. 

Chlorate of Potash Mixture. 

R. — Liq. chlorid. sodas, ^ss; 
Potass, chlorat. ^i; 
Aquge cinnam. ^vi. 
Mix. Dose, a tablespoonful two, 
three, four times a day. 

Acidulated Cinchona Mixtures. 

1. R. — Infus. cinchonas, ^vi; 

Acid, hydroch. dilut. gi; 
Pulv. serpent rad. 
Pulv. cayenne, aa ^i; 
Syr. zingib. ijij ; 
Mix. Dose, a tablespoonful five or 
six times daily. 

2. R. — Decoct, cinchon. ^vi. 

Elix. vitriol, gi ; 
Tinct. opii, £ss. 
Mix. Take one-third of the whole 
for a dose. 



Copaiba Mixture. 

R. — Copaibas opt. giij ; 

Mucil. g. Arab. t |iss ; 
Mix, and add, gradually, 
Aquas cinnam. ^iiiss; 
Carb. sodas, £i ; 
Tinct. opii, giss; 
Aq. lavend. ^ss ; 
Mix. Dose, a tablespoonful five or 
six times a day, shaking the bottle 
frequently. 

Diaphoretic Mixtures. 

1. R.— Spt. nit. dulc. ^ss; 

Liq. ammon. acet. 25 ij ; 
Pulv. ipecac, ^i ; 
Antim. tart. grs. ij ; 
Camphor, grs. iv ; 
Morph. sulph. gr. i; 
Aquas, gij. 
Mix. Dose, a tablespoonful every 
hour or two. 

2. R. — Antimon. tart. grs. ij ; 

Spt. mindereri, ^iv; 
Acet. morph. gr. i. 
Mix. Dose, a teaspoonful every fif- 
teen minutes. 

3. R. — Vin. antimon. 

Acet. scillae, aa gi. 
Mix. Dose, a teaspoonful every half 
hour. 

Camphorated Mixtures. 

1. R. — Camphoras, gi; 

reduce to powder with 
Alcohol, lT[xx; 
Magnesia carb. ^ij ; 
Sacch. alb. gij ; 
Aquse fervent. Oi. 
Mix. Dose, a tablespoonful repeated 
frequently. 



2. R. 



Mix. 



-Camphoras, 9i; 
Magnes. carb. gi ; 
Pulv. g. Arab, ^iss ; 
Morph. sulph. gr. i ; 
Aq. rosar. ^vi. 



3. R. — Camphoras, grs. x ; 
Alcohol, 1T[vi; 
Sacch. alb. 
Pulv. g. Arab. 
Magnes. carb. aa ^ij ; 
Aquae, ^vi. 
Mix. 



MIXTURES. 



593 



4. R. 



Mix. 



-Camphoras, ^ss ; 
P. gum Arab. 
Sacch. alb. aa gij ; 
Magnes. carb. ^ss ; 
Morpli. sulph. gr. i; 
Aqua? menth. ^vi. 

Carminative Mixtures. 



1. R. — Magnes. sulph. ^ss ; 

Magnes. carb. giss ; 
01. anisi, 

01. menth. p. aa Hlv; 
Aq. cinnam. ^viij. 
Mix. Dose, a tablespoon half full to 
a child two or three years old. 

2. R. — Sem. cardam 

Sem. carui, 

Sem. foenic. dulc. aa gij ; 

Aquae bullient. gviij. 
Digest an hour, and strain ; to the 
cleared liquor add 

Magnes. sulph. gij ; 

Magnes. carb. gss ; 

Sacch. alb. gij. 
Mix. 

Cathartic Mixtures. 

1. R. — Infus. sennas, ^viij ; 

Sodas sulph. 
Magnes. sulph. aa gi ; 
Sacch. alb. ^ss ; 
01. cinnam. ffl x - 
Mix. 

2. R. — Rad. rhei contus. 

Sennas fol. aa ^ij ; 
Magnes. sulph. 
Tart, potass, aa ( ^ss; 
Aq. bullient. ^x. 
Digest for half an hour, and strain. 

Diuretic Mixtures. 

1. R. — Antim. tart. gr. i; 

Potass, bi-tart. giss ; 
Sodas bi-bor. gss ; 
Spt. nit. dulc. ^ss ; 
01. juniperi, ^ss; 
Morph. sulph. gr. i; 
Aquas, ^viij. 
Mix. Dose, a tablespoonful every 
second hour. 

2. R. — Potass, bi-tart. gij ; 

Sodas bi-bor. spj ; 
Aq. foenic. dulc. ^viij ; 
01. juniperi, 7)i; 
Spt. nit. dulc. 25 ss; 
Morph. acet. gr. i. 
Mix. Dose, same as the last. 



3. R. — Baccas junip. contus. gvi; 

Sem. carui, 
Sem. cardam. aa £i ; 
Aq. fervent. Oi. 
Digest for three hours ; to the strained 
liquid add 

Potass, nit. ^ij j 
Syr. scill. Jss. 
Mix. Dose, a wineglass half full 
every two hours. 

4. R. — Pulv. gum Arab, gv; 

Sapon. Cast, ^ss ; 
Potass, carb. ^ij ; 
Potass, nit. £)i; 
01. juniper, ^i : 
Aquas, Oi. 
Mix. Dose, a tablespoonful fre- 
quently. 

Emetic Mixtures (active.) 

1. R.— Sulph. zinc, ^ij ; 

Aq. menth. p. ^iv; 
Mix, and add 
Pulv. ipecac, gss. 
Mix. Take one-third for a dose, and 
repeat in ten minutes. 

2. R. — Antim. tart. grs. x; 

Aq. menth. p. ^v ; 
Mix, and add 
Vin. ipecac, ^i. 
Mix. Divide into four parts, to be 
taken at intervals of half an hour. 

Expectorant Mixtures. 

1. R. — Pulv. gum Arab. 

Vin. ipecac. 
Syr. scill. aa ^i ; 
Syr. tolut. ^ss; 
Aquas, ^iv. 
Mix. Dose, a tablespoonful. 

2. R. — Succ. glycirr. 

Pulv. gum Arab. 
Sacch. alb. 

Rad. polyg. sen. aa ^ss ; 
Aquas bullient. Oi. 
Digest an hour, and strain. Dose, a 
teaspoonful frequently. 

3. R.—Oxymel scill. |i; 

Ant. tart. gr. i ; 
Pulv. gum Arab. 
Sacch. alb. aa gij ; 
Aquas, ^v. 
Mix. Dose, a tablespoon half full 
frequently. 



594 



MIXTURES — MOLASSES. 



Febrifuge Mixtures. 

1. R. — Ant. tart. gr. i; 

Pulv. gum Arab, ^i: 
Tinct. opii, "$i ; 
Aquse, J vi. 
Mix. Dose, a teaspoonful every fif- 
teen minutes. 

2. R. — Camphorse, ^ss ; 

Pulv. gum Arab, gij ; 
Nit. potass, ^ss ; 
Ant. tart. grs. iij ; 
Spt. nit. dulc. ^ss ; 
Aquae, Oi. 

Mix. Dose, a teaspoonful every 
half hour. 

Anodyne Mucilaginous Mixture. 

R. — Mucil. gum Arab, Jiij ; 
Oxymel scill. ^i ; 
Morph. sulpli. grs. ij ; 
Syr. simp. ^i. 
Mix. Dose, a tablespoonful three or 
four times a day. 

Nervine Mixtures. 

1. R. — Camphorse, 

Gum foetid, aa gi ; 
P. gum Arab, gij ; 
Ammon. spt. aromat. ^ss ; 
Aquse, %y. 
Mix. Dose, a tablespoonful. 

2. R. — Camphorse, gss ; 

Aromat. spt. ammon. gij ; 
spt. nit. dulc. ^ss ; 
Muc. gum Arab, ^ij ; 
Aqus3, ^iij- 
Mix. 



Mix. 
day. 



Strychnine Mixture. 

R. — Strychnia, grs. ij ; 
Acetic acid, spj. 

Dose, six'drops three times a 



Fetid Expectorant Mixture. 

R. — Gum foetid, ^ss ; 

Aquse menth. ^iv; 
Rub these together, and add 

Vin. antimonii, £i ; 

Syr. scill. 

Pulv. gum Arab, aa £ij. 
Mix. 

Anti- Cholera Mixtures. 

1. R. — Tann. acid, grs. x; 

Sulph. morph. grs. ij ; 
Aromat. spt. ammon. 
Tinct. capsici, aa ^ss ; 
Aquse camph. ^iv. 
Mix. Dose, teaspoonful every hour. 

2. R.— Tinct. catech. 

Tinct. gall, aa ^ij ; 
Tinct. opii, ^ss ; 
01. cajeput. gss ; 
Camphor, ^i- 
Mix. Dose, teaspoonful every hour. 

3. R. — Ammon. aromat. spt. ^ij ; 

Terebinth, spt. ^ss; 
Camphor spt. t ^ij ; 
Morph. sulph. grs. x ; 
01. cajeput. £)i. 
Mix. Dose, teaspoonful every hour. 

4. R. — Rhatan. ext. gij ; 

Acid nit. ^ss ; 
Tinct. opii, gij ; 
Aquse camph. ^iv. 
Mix. Dose, teaspoonful every hour. 



Molasses. — As this familiar term occurs frequently in this 
volume, it is proper to say that between this and treacle, so often 
named in the older books, there is not a very great difference. 
The former is the brown, saccharine, viscid fluid which drains 
from raw sugar when placed in hogsheads, and is used in the 
preparation of brown sugar. The latter is a viscid, dark-brown, 
uncrystallizable syrup, which drains from the moulds in which 
refined sugar concretes. These liquids result from an alteration 
effected in cry stalliz able sugar, and do not exist in the sugar- 
cane. Both contain free acid. 

The chief use of molasses, in medical practice, is in modifying 
various closes that would be otherwise disagreeable, in preparing 
injections, &c. By some, burns and scalds have been happily 
treated by covering the whole injured surface with molasses. The 



USES OF MONESIA. 595 

parts are thus protected from the action of the air and from in- 
jury by other external causes. As a simple remedy for irritative 
coughs, molasses, in the form of candy, is often useful. Very 
recently it has been stated that a case of intus-suscejitio, in which 
the usual means failed, yielded readily to a pint of heated mo- 
lasses, swallowed in a few minutes. Whether the remedy acted 
by its weight or bulk, or lubricating or cathartic qualities, is not 
stated by the writer. — Journal of Health, 1857. 

Monesia. — This was first announced as a new product of the 
vegetable kingdom by Dr. St. Ange, in the Gazette Medicate for 
1839. It has been noticed frequently since in the foreign and 
American journals. It was imported from South America in 
hard, thick cakes, each weighing less than twenty ounces. The 
cakes are said to be a sort of extract made of the bark of a tree 
the botanical name of which is not mentioned, and perhaps is 
unknown. The druggist who first introduced it to the Parisians 
says that certain travelers called the bark that yields monesia by 
the name goharen, and also buranhem, the import of which is not 
stated. Naturalists who have examined specimens of the bark 
think it a species of chrysophyllum. When the cake or extract 
is fractured it looks not unlike roasted cocoanut. It is quite 
soluble in water. Its taste is sweetish and a little like that of 
liquorice, then rather astringent, and leaves finally an acid taste 
that is felt on the tonsils. The bark which yields this cake is 
said to be smooth and gray, with a sweetish taste. Chemical 
analysis gives the following components, viz. : chlorophylle, vege- 
table wax, a fatty and crystalline matter, glycirrhizine, an acrid 
and bitter matter, some tannin, a peculiar acid, red coloring 
matter, phosphate of lime, &c. 

Various pharmaceutical preparations have been made and ad- 
ministered as an extract, syrup, tincture, and ointment. The 
syrup contains thirty grains of monesia in an ounce ; the hydro- 
alcoholic tincture, thirty-seven grains to the ounce. The oint- 
ment contains one-eighth of its weight of the extract of monesia. 

Monesia is given in doses of from fourteen to twenty-four 
grains daily, for ten days, in the form of pill, tincture, or syrup. 
It exerts a decided effect on the digestive organs, and evidently 
improves the condition of the stomach. It has been pushed to 
seventy-four grains daily with the effect of sensibly improving 
the appetite. Such large doses, however, sometimes act as 
an irritant, inducing tenesmus and obstinate constipation, and 
therefore it should be alternated with an occasional aperient or 
injection. 

The ointment has been found useful in various kinds of cuta- 
neous disease, and in painful ulcers consequent on the action of 



596 VALUE OF MUSK. 

blisters in sores caused by burns, in varicose ulcers and old 
wounds. 

The extract lias been happily employed for the relief of scor- 
butic gums, after other means had failed. Externally and in- 
ternally it has been found useful in scrofula, and in uterine 
hemorrhage its internal administration has been salutary. 

Dr. Nancrede, of Philadelphia, made trial of it in diarrhoea 
and dysmenorrhea, with good effect. Dr. Burns gave it in 
menorrhagia, haemoptysis, chronic diarrhoea, and cholera in- 
fantum, with benefit. Dr. Gibbon, of New Jersey, furnishes 
six cases of diarrhoea treated successfully with monesia. (See 
Dunglisons Medical Intelligencer, January, 1842.) His doses 
were eight grains three times a day for an adult, and two grains 
three times a day for a child eighteen months old. He regarded 
it as an astringent rather than a tonic. 

Dr. Lane, in the London Lancet for October, 1843, confirms 
the statements previously made touching the properties of the 
article, believing them to be analogous to those of kino and 
catechu. 

It is proper to say, however, that at a meeting of physicians 
in London, in 1843, Dr. Sigmund declared that monesia had 
been ascertained to be a compound drug, made of various arti- 
cles. But, even admitting this to be true in the fullest sense, it 
is no valid objection to it as a remedial agent, if the testimony 
as given above should find confirmation hereafter. 

Moschus. Musk. — This is an unctuous substance, obtained 
from an animal called mush or musk-deer, a little like the ante- 
lope. It is procured from the navel of the male, and is found, 
in a bag or sac. The best musk is brought from China, and is 
of a very brown color, and sometimes almost black. The odor, 
which is the best evidence of good quality, should be very strong 
and pervasive. The taste of the best musk is bitter. In 
respect of its medical and chemical properties musk resembles 
castor. 

Musk has always been classed with stimulants and antispas- 
modics. The ordinary adult dose varies from three to five 
grains. It is employed in various nervous affections, as hysteria, 
singultus, &c. &c. It is capable of exerting a happy influence 
on the subsultus tendinum of low fevers, and has been very 
highly praised in cholera for its agency in checking vomiting. 
It is administered in form of bolus, julep, and injection. 

I never employed it more than once for any medicinal pur- 
pose, and am much inclined to believe that it will not long be 
esteemed a very important aid in practice. 

The term artificial musk has been applied to a compound 
made by digesting amber in nitric acid. The product is a yel- 



MOXA — MUSHROOMS. 597 

low mass, with an odor somewhat like that of the native musk, 
and possessed of stimulant and antispasmodic properties. It 
has been employed in this city in pertussis. 

Moxa. — This is a Chinese invention for the purpose of effect- 
ing counter-irritation. Various devices were employed for this 
end, but always some substance of ready combustibility. This 
being kindled, was brought into close contact with the surface 
of the part affected. Cotton, finely carded and saturated with 
a solution of nitrate of potash, and then thoroughly dried, fur- 
nishes a very good article for this purpose. Perhaps there is 
not an article capable of acting more promptly, and neatly at 
the same time, than potassium. It becomes at once an actual 
and potential cautery, and is therefore a real moxa. To this 
end a small bit of the metal is laid on a given spot, first moistened 
with a very little water. The metal is fired instantly ; and, being 
converted into pure or caustic potash by the act of combustion, 
accomplishes the results named. A particle not larger than a 
pigeon-shot will suffice. 

The London and Edinburgh Monthly Journal of Medical 
Science for March, 1842, has the account of a lime moxa, as 
follows : — A small piece of quicklime is applied to the skin so as 
to be confined to the spot, and a drop or two of water is brought 
in contact with it. The lime swells and emits intense heat, equal 
to 500° Fahr. The effect is proportioned, of course, to the 
length of time the lime is kept on the part. Dr. Osborne, who 
communicates the fact, prefers this moxa because it is free of 
sparks or fire, and is sufficiently prompt. 

All sorts of moxas act on the same general principle in the 
cure of disease, as blisters, setons, issues. The effect and opera- 
tion of such remedies is shown by cases of epilepsy suddenly 
cured by deep burns. (See North American Medical and Surgi- 
cal Journal, vol. v.) 

Mr. Gilbert, in a work on pulmonary consumption, thus notices 
the effects of a most painful accidental moxa. A young lady 
labored under tubercular phthisis, and accidentally took fire; 
the upper part of her body, especially the chest, was badly 
burnt. The phthisical symptoms were quickly relieved. The 
lady got well, had no return of cough nor other attendant of 
tubercular disease of the lungs. — Medico-Chirurgical Review, 
July, 1842. 

Mushrooms. — The number of the species of the article com- 
monly called mushrooms that are decidedly poisonous has not 
been, and perhaps cannot be, definitely settled. Even close 
familiarity with the different species, for reasons to be named 
hereafter, cannot wholly avoid danger. The details necessary, 
in an attempt to point out the distinctions, even so far as they 



598 PECULIAR EFFECTS OF MUSHROOMS. 

are supposed to be known, would occupy more space than we 
can spare, and are of less practical value than has been imagined. 

It is affirmed that the qualities of these articles are modified 
by circumstances, so that some which are ordinarily poisonous 
may become inert, or even esculent, and vice versa. That cli- 
mate has some effect on their properties is evident, for some 
that are quite poisonous in one country are eaten with impunity 
in others. Cultivated in the same region, or growing sponta- 
neously, the quality is much influenced by the weather, so that 
a long continuance of rain develops properties of a highly per- 
nicious nature. 

The very best mushrooms are also affected by the process of 
cookery. In the raw state, all of them are indigestible; but, 
under the operation of a suitable degree of heat, this quality 
vanishes. Nor should it be forgotten that many persons are 
unable to partake of any kind of mushrooms in whatever way 
prepared. This may be owing partly to idiosyncrasy, but is 
also somewhat dependent on the natural disrelish for the article, 
which, if taken as a matter of mere experiment, induces nausea 
or vomiting, followed by painful colic and diarrhoea. And there 
would seem to be good reason for the opinion expressed by some 
intelligent botanists, that the best kind of mushrooms could not 
be tolerated by any one, as a daily dish; the experiment, so far 
as it has been made, proving that deleterious results would ensue. 

Various efforts have been made to ascertain wherein consists 
the poisonous principle of mushrooms of any kind and under any 
circumstances. We are not sure that any one of these has been suc- 
cessful, nor have we good reason to hope for satisfactory results* 
Letellier supposes he has detected two principles, as the source 
of the evil. One of these is an acrid matter, so exceedingly 
volatile as to fly off when the plant is dried, or boiled, or mace- 
rated in weak acids, alkalies, or alcohol. To this principle he 
attributes the irritant properties of some mushrooms. The nar- 
cotic property, according to his researches, is more fixed, as 
would appear from its resistance of the drying process, the opera- 
tion of boiling, and the agency of acids and alkalies. This 
principle is soluble in water, has no smell nor taste, and forms 
crystallizable salts. 

The symptoms induced by poisonous mushrooms are exceed- 
ingly variable, but almost always a mixture of the usual products 
of irritant and narcotico-acrid poisons. In some cases the irri- 
tant, and in others the narcotic symptoms appear to preponde- 
rate. Urgent dyspnoea, scorching thirst, tormina of the bowels, 
abdominal tension, and profuse diarrhoea supervene. Dimness 
of vision, giddiness, delirium, and coma constitute the usual 
narcotic symptoms. Convulsions and fainting are sometimes 



POISONOUS ACTION OP MUSHROOMS. 599 

noticed. These distressing effects are not always observed until 
several hours after the poison has been swallowed; yet they do, 
now and then, appear in a half hour, or even less. 

We have said that esculent mushrooms may sometimes prove 
hurtful, and the remark is confirmed by the following case, 

recorded in the London Lancet for July, 1839: — "F. B , 

aged 25, Ann B — — , his wife, aged 23, and their child, aged 4, 
gathered a quantity of mushrooms on the morning of August 
20, 1830, with a view to sale. They could not dispose of them 
all, and, on going home, cooked the stock on hand and ate them, 
with the addition of nothing but water. In a half hour they 
were quite giddy, and the giddiness increased to dimness of sight. 
The hearing became painfully acute, and objects were seen im- 
perfectly. The husband fancied himself involved in flame, and 
felt a sentiment of uncontrollable gladness that prompted to 
muscular movements. The wife gave a similar account of her- 
self; but the condition of the child could be gathered only from 
the obvious state of excitement. 

"An hour after the meal, Mr. Edwards saw the family, and 
supposed that all were drunk, as they were exhibiting feats in- 
dicative of a state of inebriation. Their countenances exhibited 
great hilarity, and yet consciousness was unclouded. The man 
was most vividly affected; his eyes glistened, the pupils expanded, 
the pulse was full and frequent, the tongue clean, and the breath 
untainted. He conversed without embarrassment, and appeared 
entirely rational. 

"The sulphate of zinc was employed, but to no purpose. The 
stomach-pump was next resorted to, and by it some half-digested 
mushrooms were removed. This gave considerable relief, and a 
few leeches to the temple completed the cure. It is proper to 
add that no other persons were injured by the mushrooms gathered 
by this family." 

The following cases evince the irritant as well as the narcotic 
effects of the poisonous mushrooms very clearly: — A man, his 
wife, and three children and a servant, dined on fish stewed with 
poisonous mushrooms. The wife, the servant, and one child had 
vomiting, followed by stupor, but all recovered. The husband 
experienced violent cholera, but he got well also. The other 
children became profoundly lethargic and comatose ; could not 
be vomited, and soon died, without exhibiting any other remark- 
able symptoms. Here was pure irritation, and obvious nar- 
cotism, from one and the same cause, operating on different con- 
stitutions. 

The treatment, as above noticed, consisted mainly in a resort 
to general principles ; for it was but recently that a true antidote 
for the mushroom poison was announced. The following state- 



600 PROPERTIES OF MYRRH. 

ment by M. Chansarel, taken from Journal de Chimie Medicale 
for April, 1839, will speak for itself. " The use of vinegar as a 
remedy for mushroom poison is improper, because the acetic acid 
dissolves the energetic portion of the vegetable and irritates the 
parts inflamed by the poisonous matter. The true antidote is 
nut-galls, or rather the tannin contained in them. If nut-gall 
be used, add one ounce, bruised, to a pint of hot water, and give 
the clear infusion in wineglassful doses, oft repeated. In lieu 
of this, add from thirty to forty grains of tannin to a pint of 
water, and give it in the same way." Whatever be the poisonous 
base of the mushrooms, the tannin most probably forms, in union 
with it, an inert and harmless compound. 

The morbid condition noticed after death has not been fixed 
with sufficient accuracy. The appearances observed are lividity 
of the surface of the whole body, fluidity of the blood, distension 
of the abdomen, inflammation and gangrene of the stomach and 
bowels, and venous congestion of the lungs. The sinuses 'of the 
dura mater have been found enormously distended with blood, 
the substance of the brain quite red, and a large clot of blood 
has been taken from the cerebellum. 

Myrrh. — This is affirmed to be a product of the Balsami- 
dendron myrrha, but whether obtained spontaneously or by 
artificial means is not known certainly. It is a gum-resin, and 
composed of thirty-five resin and sixty-five gum in a hundred 
parts. Myrrh is one of the medicinal substances named in the 
Bible, and is therefore of great antiquity. It is imported from 
the Levant and East Indies, and is usually met with in irregular 
lumps in pieces of variable size, many of which are nearly globu-. 
lar. It has a reddish-brown color, is opake, quite brittle in cold 
weather, but adhesive in warm and moist weather. When broken, 
the interior presents a much brighter appearance than is exhibited 
by the exterior. The taste is rather bitter, and a slight aroma 
is obvious. The dark-colored pieces are not prized, as are those 
of a bright or light red. The gummy part is taken up by water, 
the resin by alcohol, and the whole is dissolved by brandy or 
diluted alcohol, thus making a tincture. 

The best myrrh adheres to the teeth when chewed, and whitens 
the saliva, an effect that is due to insolubility of the resin in the 
watery portion of the saliva. 

Myrrh is tonic, stimulant, expectorant. The latter property 
fitted it for the treatment of humid asthma and chronic catarrh. 
It has also been well spoken of in the exhaustion that attends 
purulent expectoration. It has been a good deal employed in 
chlorosis, and in defective menstrual discharge in pale, languid 
females ; hence it has been called emmenagogue. Its expectorant 
quality has been sometimes augmented by the addition of ipeca- 



NAPHTHA — NARCISSUS PRATORUM. 601 

cuanha or squill, or both. Regarded as a stimulant, it has been 
considered improper in affections with inflammatory symptoms. 

Myrrh may be given in powder alone, or with nitrate of pot- 
ash, opium, camphor, &c, or in form of pill in combination with 
other tonics, or in watery infusion, or in tincture. The dose of 
the powder is from ten to thirty grains ; of the tincture, from 
thirty to sixty drops in two ounces of water. The tincture can 
be readily made by digesting two ounces of myrrh in a quart of 
brandy. The compound tincture of myrrh is the number six of 
the steam-doctors, and has great celebrity in the western country. 
Its composition was stated under the article capsicum. It is a 
good rubefacient, and usefully applied to old indolent ulcers. 

The powder of myrrh has long been employed as a dentifrice ; 
and the diluted tincture is a good application to sore mouths and 
spongy gums. 

I have very seldom employed this article, and hold it to be of 
little value. 

Naphtha. Naphthaline. Pyroxylic Spirit. Pyro-acetic 
Spirit. — This is a pale, straw-colored fluid, having the odor of 
wood-smoke in its concentrated state. It is obtained in the pro- 
cess of manufacturing wood vinegar or pyroligneous acid, and 
may be found in all the drug stores. It is said to be narcotic, 
sedative, and calmative. Dr. Hastings published a book on its 
uses in pulmonary consumption, and praised it highly. He 
employed it by inhalation as well as by internal use. The jour- 
nals have abounded with notices in relation to it, and are diverse 
in their opinions. I do not believe a word of its alleged cura- 
tive powers in real tubercular phthisis, although I have no doubt 
that it may be useful as an expectorant. 

Christison speaks of naphtha as an anti-emetic, and regards 
it fully equal to creosote. The usual dose is five drops in some 
aromatic water ; a very small dose in contrast with the forty- 
drop doses given by Hastings. The Medical Examiner for Au- 
gust, 1848, speaks of its exhibition in epidemic cholera; but it 
does not seem to be entitled to great confidence in that relation. 

Having paid a good deal of attention to the discussion of the 
merits of this article, as contained in the London Lancet and 
other journals, I am satisfied that naphtha is not superior, as a 
therapeutic agent, for any purpose, to good spirits of turpentine. 

Narcissus Pratorum. — Dr. Fresnoi, of Leipsic, noticed in 
1786 the good effects of this plant in hooping-cough, which 
was then epidemic at Valenciennes. Forty-two children were 
promptly cured in a short period. Four grains of the extract 
of the plant were dissolved in four ounces of syrup, and a table- 
spoonful was given every third hour. The cough was soon 
abated, and its course very much shortened. 

39 



602 NARCOTICS — TOBACCO. 

I am not aware that this particular species of narcissus has 
been named in our books of Materia Medica. The pseudo-nar- 
cissus variety, or the common daffodil, is spoken of as emetic, 
cathartic, and antispasmodic. The latter quality seems to be 
inherent in the genus. 

Narcotics. — The word comes from the Greek, and means to 
stupefy. The import of the term is, a stupefying power of cer- 
tain medicines, in virtue of which they diminish the activity of 
the nervous system. Generally speaking, narcotics have a sti- 
mulating power, and this is manifested chiefly when they are 
given in small doses, while a full dose produces a narcotic effect 
at once, without any evident stimulation preceding it. A de- 
cidedly over-dose, on this principle, will destroy life without any 
other than a directly narcotic manifestation. 

Narcotine. — This is one of the numerous constituents of 
opium, and gives rise to all the unpleasant effects of that medi- 
cine. It is obtained in small, colorless, prismatic crystals, which 
are nearly insoluble in water, and composed of carbon, hydro- 
gen, and nitrogen. It is decidedly poisonous, and has never 
been exhibited in any form of disease per se. Some of its salts 
have been employed in the East Indies in intermittents, but they 
are now rarely heard of. 

Nickel. — The sulphate of this metal has been brought to 
notice, as a gentle tonic, by Prof. Simpson, of Edinburgh. He 
has given it in half-grain or grain doses, thrice per day, in solu- 
tion and also in pill. Large doses act as an emetic. It is best 
exhibited half an hour after a meal. It has been found to cure 
inveterate headaches which have long resisted ordinary treatment. 
In chlorosis and amenorrhoea it has also been very useful in the 
most obstinate cases. 

As nickel is a very hard metal, it will require a spirit-lamp 
heat to form a perfect solution in sulphuric acid. — Braithwaite, 
p. xxvii. p. 340. 

Nicotiana Tabaci Folia. Tobacco. The leaves. — This is 
indigenous to America, and can be cultivated in all temperate 
latitudes, though easily injured by a premature frost. It is 
affirmed that not an animal in the universe will eat the green 
plant save the mountain goat, nor will he except he be very hard 
pushed for food. It was called nicotiana after Jean Nicot, 
French ambassador at the court of Lisbon, who did much to 
extend its cultivation. It was called tobacco from Tobasco, the 
place where the Spaniards first smoked it; or from tabac, the 
name of the instrument or reed employed by Americans in 
smoking the leaf before pipes were known. Prior to 1580 it 
was cultivated in Spain, France, Italy, and Portugal, and intro- 
duced into England by Sir Walter Raleigh, whose example 



PROPERTIES OF TOBACCO. 603 

brought it into general use. The various edicts and anathemas 
against it, and especially the famous counterblast of King James, 
have long been before the public. While they indicate clearly 
enough the excesses perpetrated in regard to it, they show, with 
equal plainness, how difficult it is to denounce an evil out of ex- 
istence. They warrant the inference, too, of the better way, 
viz., to kill it and every other odious custom by a persistently 
good example. The likeness, as respects evil and cure, to alco- 
holic drinks, is too palpable not to be recognized, if we permit 
our eyes to be open. We may lecture by the year, and so try 
to persuade the mass to do right ; but the labor will be lost in 
both cases, unless we can persuade the good men — preachers of 
the Gospel and others in authority and high in respectability — to 
take an immovable stand on the right side. There lies the 
secret of success. 

That tobacco acts badly on the human economy no sober man 
will deny. We do not mean to say that all who use it long and 
often are obviously injured; but we do affirm that it is an unsus- 
pected yet real cause of a hundred ills that are attributed to 
some other source. We know this to be true from large observa- 
tion touching this very thing, for it has occupied our special 
attention. And as we never touch nor taste the nasty weed in 
any form, we feel that our hands are clean when we investigate 
the subject, nasty as it is. 

Tobacco acts as a local stimulant primarily, but it is also a 
very sure narcotic. Apply it to the nose of one who never be- 
fore felt its influence, and severe sneezing proclaims its stimu- 
lant power loud enough, while the increase of the natural mucus 
demonstrates the same agency. That snuff-takers do not realize 
such results is a confirmation rather than a negation of this 
assertion ; for in them the law of habit displays its mighty power 
to convert painful into pleasurable sensations; and for that 
reason alone does snuff fail to stimulate the Schneiderian mem- 
brane, already coated with impervious layers of the article. 

But tobacco does more. It seriously impairs the voice in 
many instances. It induces dyspepsia, gastrodynia, headache, 
and many other morbid states. It is reported on good authority 
that even deafness has been occasioned by snuff, gradually accu- 
mulated so as to impair the organ of hearing, and at last cured 
by the ejection of hard snuff-balls, like pills, in the act of 
coughing. 

That tobacco is unfriendly to insect life is abundantly proved 
by its power over moths, as all housekeepers well know. Wash- 
ington Irving, in his Astoria, affirms that the surest protection 
from the visits of snakes within the tents of his exploring com- 
pany was the tobacco leaf freely spread along the earth's sur- 



604 PROPERTIES OF TOBACCO. 

face immediately under the edges of the tents. Not a snake 
ventured across the sure, though simple barrier. It is also 
stated that the oil collected in old tobacco pipes is instantly 
fatal to all venomous reptiles in the smallest quantity. In this 
relation we may remark that serious results have followed the 
inunction with snuff ointment of the heads of children labor- 
ing under scald head, such as vomiting, fainting, profuse sweats, 
and even apoplexy. A case is reported in the New York re- 
print of the London Lancet, vol. i., of all the usual symptoms of 
phthisis pulmonalis following the excessive use of snuff, and re- 
covery from the simple expedient of laying the poison aside. 
Borricheus tells the story of a man who used snuff so long and 
so profusely that his brain was reduced to a brownish-black 
mass. The celebrated work of Tissot, On the Disorders of Men 
of Letters, furnishes much valuable testimony in this connection, 
and should be extensively read. I only add just here that one 
of the most distressing cases of gastrodynia I ever met with 
was occasioned by smoking and chewing tobacco, and cured in 
a short time by abandoning the practice.* 

To show how deep an impression is made on the nervous sys- 
tem by long devotion to the use of tobacco, in chewing, smoking, 
or snuffing, we give the case of an. old gin-sot and habitual cigar- 
smoker who was under treatment for a severe burn. She was 
under the care of Mr. Curling, who is good authority. Stimu- 
lants were freely allowed, because of the ascertained habits of 
the patient ; but she soon showed palpable signs of delirium tre- 
mens. The fondness for tobacco having been discovered, she 
was indulged in smoking, which was just the thing her case de- 
manded. She became tranquil and slept well. There was no 
more delirium, and she was soon discharged. " Prevention," 
says Mr. Curling, "is always better than cure," which is a 
friendly hint to avoid tobacco altogether, just as it is best to 
eschew strong drink. 

But bad as tobacco is in the relations stated above it is some- 
times a good medicine; and it is only as a remedy that it should 
be retained in civilized society. The smoke of the weed, the 
infusion and decoction, are all powerfully emetic. On this ac- 
count they have been resorted to in cases of strangulated hernia, 

# We do not vouch for the truth of the following, furnished by a Boston cor- 
respondent of the Hampshire Gazette, very recently. "Sharks abound on the 
sea-coast so fearfully in the present season that few persons dare indulge in 
the luxury of sea-bathing, save the most inveterate tobacco-chewers, who can 
swim "outside" with entire impunity, as the sharks (like cannibals) will not 
touch human flesh tainted with the filthy and poisonous weed. This is sup- 
posed to account for the large increase of the tobacco-habit among young men 
who visit watering-places." The writer marks this as one of the benefits of to- 
bacco to the race. 



TOBACCO INJECTIONS. 605 

to avert a surgical operation. The universal relaxation induced, 
in connection with the severe gastric sickness, often unlocks the 
spasm or stricture and frees the bowel from its dangerous posi- 
tion. For the same reason, the remedy has been useful in obsti- 
nate constipation, in tetanus, and hydrophobia. Being an ex- 
ceedingly energetic remedy, it should be restricted to very 
judicious hands. 

The Germans have made a neat yet simple instrument for 
exhibiting the smoke injection. It has a chamber lined with 
tin and perforated with small holes, in which the dried tobacco 
leaf is placed and kindled; a tube opening into this chamber 
favors the escape of the smoke, and another tube at the upper 
part allows the mouth to be applied, in order to force the smoke 
into the rectum. The smoke injection is preferable to the de- 
coction, because more likely to escape, and hence more readily 
controlled. A sedative action always ensues, and sometimes 
with fatal results. 

The infusion is variously made; from a drachm to an ounce 
of tobacco leaf, in a pint of hot or boiling water, according to 
the end in view, being the proportions. A few ounces of the 
infusion thrown up the rectum will induce speedy relaxation of 
the entire system, and hence its use in strangulated hernia. 

An hysterical girl, aged eighteen, who had been long costive, 
took a tobacco injection made by boiling three drachms of com- 
mon tobacco in a pint of water. The whole was thrown up the 
rectum at once. In half an hour she complained of faintness 
and sickness ; in a half hour more she was collapsed and covered 
with cold sweats. She vomited, was slightly convulsed, and 
died in an hour and a half after the injection was administered. 
(See London Lancet, March, 1850.) 

Injections of tobacco decoction thrown up the nostrils dally 
for a week or ten days caused the expulsion of maggots or 
worms from the nose, that had occasioned very severe suffering 
to the patient. At first the injection was painful', but in a day 
or two it was rather the reverse, and it corrected the fetor of 
the discharge from the nose completely. (See Medical Com- 
mentaries, vol. iv.) 

The infusion is also employed in ischuria, with benefit. For 
this end some add only a drachm to a pint of boiling water, 
and of the clear liquor they give from ten to fifteen drops for a 
dose, every ten minutes, until the stomach is sickened. The 
urine soon flows freely, after the exhibition of a very few doses. 
The same article has been administered also in dropsy in the 
same doses. 

Tobacco leaf soaked in hot vinegar and laid over the epigas- 
trium induces vomiting very promptly, and is a good expedient 



606 USES OF TOBACCO. 

when you cannot introduce an emetic into the stomach. I found 
it to answer admirably in a case of deep intoxication, with 
the jaws so fixed as to preclude the introduction of an emetic 
in the usual way. The man was roused in a few minutes 
effectually. 

The leaf prepared in the same manner has been tried very 
satisfactorily as a local application to an old tetter on the inferior 
extremities, and when so used it is apt to induce decided nausea. 
The same application has proved salutary in the onset of croup, 
the leaf, thoroughly wet with hot vinegar, being bound close to 
the throat and neck. On the same principle the snuff cerate of 
the late Dr. G-odman has been resorted to in the same disease, 
and sometimes with success. 

A writer in the Edinburgh Medical and Surgical Journal, 
vol x., advises an injection of tobacco made of twenty-five grains 
to twelve ounces of boiling water, for the arrest of pneumonic 
inflammation after the use of the lancet, and also in cynanche 
tonsillaris. He affirms that the stricture of the chest and pain 
in the former, and the pain and swelling of the latter, are speedily 
abated. 

We named injections of tobacco as a remedy for tetanus, but 
it is proper also to notice the use of a tobacco-bath, long ago 
employed in Trinidad with success. Dr. Anderson furnishes 
some facts in this regard in the Edinburgh Medic o-Chirurgical 
Transactions. Four ounces of the dried leaves were boiled for 
one hour in eight gallons of water, and the whole added to a 
tepid water-bath. It is stated that injections of tobacco were 
employed at the same time. The continuance of the patient in 
the bath was governed entirely by its obvious effects. 

In the journal just named, Dr. Vetch praises the tobacco in- 
fusion as an external application of great value in gout, rheu- 
matism, affections of the synovial membranes, &c. &c. He says 
the remedy not only assuages pain, but aids the parts in regain- 
ing their former tone and vigor. The antipodagric or antigout 
powers of tobacco were insisted on by some of the earliest ad- 
mirers of the weed ; and if it could be so administered as to 
maintain a perpetual nausea for six months, I think its virtues 
would not be questioned. The low diet necessary to such a state 
of the digestive organs would probably work a salutary reforma- 
tion in the blood and tissues, and so effect a cure. 

The infusion of tobacco was employed by Dr. Fowler in 
eighteen cases of dysentery with the effect of curing eleven and 
relieving seven. He gave it in different forms. He digested an 
ounce of the leaves in a pint of spirit or of vinegar, and began 
with from ten to twenty-drop doses. Sometimes the pill form 
was resorted to according to the following prescription : — 



USES OF TOBACCO. 607 

Take of powder of tobacco, 

Conserve of roses, each a drachm ; 
Mucilage, enough to make sixty pills. 

A pill was administered three times a day. 

Under this treatment it is said that amendment soon took 
place ; and I suppose the action was not unlike that displayed by 
ipecacuanha in the treatment of the same disease. The latter 
would seem to be the safer medicine of the two. 

Dr. John W. Moore states, in a Mobile paper, that he cured 
one hundred or more extreme cases of cholera, not losing one, 
by the use of tobacco. He administered it in the form of an 
enema, of the strength of one drachm to a pint. He first tried 
it upon a negro whose pulse was gone ; his tongue was cold, and 
his muscles so rigid that he rested only on his head and heels. 
In five minutes he was relieved, and the cure perfected by drink- 
ing a decoction of senna. In his own case, Dr. Moore took 
into his stomach a spoonful of the tobacco decoction, with per- 
fect relief from cramp and diarrhoea. He has no doubt but that 
cholera may be as easily managed as the fevers of our country. 

Those who have not been accustomed to the use of tobacco 
often find relief from the distress of asthma by smoking. Others 
have taken the infusion so as to excite nausea and free expecto- 
ration, and thus have been relieved. In this connection it may 
be well to mention an incident that occurred some years ago in 
London. Lobelia inflata had been highly extolled as a remedy 
for asthma, and was sold largely by a certain drug house as a 
remedy for that disease. At length the entire stock was ex- 
hausted, and it became necessary to meet the calls for it in the 
best way that could be devised. The fumes of tobacco being 
appreciated in reference to the same malady a large quantity was 
worked into the spirituous and ethereal tinctures, and an adver- 
tisement announced a fresh supply of the favorite medicine. 
Large sales were effected, and the substitute accomplished won- 
ders. The deception was not detected until many months had 
elapsed, and the people were none the worse for the cheat. 

Strange as it may seem to many, tobacco has been employed 
as a remedy for scarlatina by some of the German practitioners. 
It was resorted to during an epidemic prevalence of the disease, 
and with success. From a quarter-grain to two grains of the 
fine powder were given three or four times a day, according to 
the age of the child. If the case presented marks of high arte- 
rial action, mercurials and antimonials were added. Expectora- 
tion was made easy, the throat was relieved, and the symptoms 
generally improved. Fifty patients were thus treated, and were 
well at the end of eight days. The medicine exerted a sedative 



608 NULLA MEDICINA. 

influence on the whole system bj emesis, diaphoresis, and diu- 
resis. 

Professor Graves speaks well of tobacco poultice to the abdo- 
men in colica pictonum. He says it generally gives the desired 
results in a short time, and has several advantages over the in- 
jection, being more easily applied and more promptly controlled. 
It is, therefore, decidedly a safer mode. Dr. James Curry re- 
ports a case of epilepsy cured by tobacco poultices to the scrobi- 
culus cordis. The paroxyms were intermittent, occurring every 
afternoon. The poultice was applied an hour before the expected 
attack, and prevented the paroxysm effectually. The case might 
have depended on some sort of abdominal derangement that was 
readily controlled by the external application. It is hardly pro- 
bable that so obstinate a disease would often yield to such simple 
treatment. 

Tobacco poultices have been resorted to for the purpose of 
destroying worms in the alimentary canal, or of expelling them 
thence. Applied to the abdomen, they must of necessity induce 
nausea and irritation of the bowels. Dr. Giles Everhard pub- 
lished a treatise on the anthelmintic property of tobacco, both 
in the form of poultice and in the shape of a syrup, administered 
internally. We have safer and better anthelmintics, however, 
and this practice will not become popular. 

Bishop Gobat, in his Journal of a Residence in Abyssinia, 
p. 367, speaks of an attack of ophthalmia, in his own person, cured 
by snuff. He says the pain was promptly relieved by frequently 
taking a pinch. He learned the use of the snuff from a negro, 
and has tried it often. Used very early, it cures in one night. 

Nulla Medicina. — This may seem a strange item in a work 
on Materia Medica and Therapeutics. It is an abbreviation of 
the famous maxim of Sydenham, that deserves to be had in last- 
ing remembrance. Nulla medicina aliquando optima medicina. 

There is nothing more certainly true than the sentiment in- 
culcated in this memorable sentence. But, says one, when and 
where is it found to be an important doctrine in practical medi- 
cine? The response is at hand. Thousands of patients are 
teased almost to death with medicine upon medicine, dose upon 
dose, until nature can tolerate physic no longer. The man or 
the woman is literally dying of the doctor and his drugs, and not 
of any real disease. The most critical moment in the whole life- 
time has been reached. Every aspect of the case proclaims "let 
the patient alone." Who has not known cases in which the 
physician's own patience became exhausted, till in despair he has 
exclaimed, "I can do no more; give the man anything he calls 
for. Die he must, and therefore gratify him." Medicine ceases 
to be inflicted on the sufferer, and from that hour he begins to 






OINTMENTS. 



609 



improve, and in a few days is out of danger. No medicine has 
signally shown itself to be the best medicine the man ever swal- 
lowed. If it were needful, cases by the score could be detailed 
to illustrate more strikingly the truth of the position, but every 
one can perceive its force at a glance. 

Nux Vomica. — As we prefer to speak of the medicinal pro- 
perties of this medicine under the head of Strychnia, the reader 
is referred to that article. 

Ointments. — The design of ointments is to offer a soft appli- 
cation containing medicinal power to an ulcerated or other sur- 
face where such qualities may be available. It follows, there- 
fore, that the substance to be incorporated with the oily or fatty 
matter should be perfectly fine, so that when the whole mass is 
thoroughly triturated no part of it should be rough or uneven, 
but that the quality should be uniform throughout. The only 
exception to this statement is found in some ointments for the 
itch, which are supposed to act the better for containing small, 
gritty particles ; as, for instance, the ointment of powdered sal 
amnionic. As almost all ointments are preferable in a sound 
state — that is, the opposite of rancidity — it is well to prepare 
small quantities at a time, and always of good materials. The 
metallic ointments, and especially those of mercury, should not be 
dealt out with metallic spatulas, as these may spoil the color of 
the ointment or give it an undesirable tinge. Wooden spatulas 
are better. The consistence of ointments being affected by tem- 
perature, it is proper to vary the fatty matter to suit this contin- 
gency : suet is a good addition, if the ointment be made in warm 
weather ; and a small portion of wax acts in the same manner. 
The following formulae for ointments will be found useful to the 
medical practitioner : — 



Tartar Emetic Ointments. 

1. R. — Antim. tart, gi; 

Adipis suill. ^i. Mix. 

2. R. — Antimon. tart, ^i; 

Adipis suill. ^i ; 
Camphorse, "^i; 
01. cajeput. TT)xv; 
Moschi, grs. iij. Mix. 

3. R. — Antim. tart, gss ; 

Adipis suill. !|i; 

01. croton. tigl. ^i. Mix. 

Compound Camphor Ointment. 
R. — Sapon. alb. ^iss; 
Camphorse, giii ; 
Spt. terebinth, ^ss; 
Aq. ammon. v\. 
Mix. 



Compound Ointment of Galls. 

1. R. — Pulv. gallse, giii; 

" opii, ^i; 
Acet. plumb, giss ; 
Cerat. simp. J iij. 
Mix. 

2. R.— Pulv. gallse, 31; 

Camphorse, ]}i; 
Pulv. opii, 
Nit. potass, aa gss ; 
Adipis suill. ^ss; 
01. cinnam. "i^ss. 



Mix. 



1. R. 



Mix. 



Iodine Ointments. 
-Iodin. gi; 
Hyd. potass. J^iv; 
Adipis suill. Jjij. 



610 



FORMULA FOR OINTMENTS. 



2. R.— Iodin. 

Hyd. potass, aa 2ji ; 
Adipis suill. ^ij ; 
Pulv. opii, ^i; 
Tinct. opii, gi. Mix. 

Ointments for Scald Head. 

1. R.— Flor. sulph. 

Ung. picis liq. aa giss ; 
Sapon. mollis, ^i ; 
Animon. hydrochlor. ^i. 

2. R.— Cal. ppt. 5 ij ; 

Alum exsic. 
Plumb, carb. aa ^ss ; 
Terebinth, venet. ^iv ; 
Spermaceti, ^iss. Mix. 

Ointment of Chloride of Lime. 

R. — Calc. chlorid. giiss; 
Turp. min. gij ; 
Mix well, and add 

Adipis suill. ^iiss ; 

01. amyg. dulc. gi. Mix. 

Sulphuric Acid Ointment. 
R. — Acid, sulph. gi; 

Adipis suill. ^i. Mix. 



Mix. 



Compound Ointment of Lead. 

R. — Cret, prepar. ^viij ; 
Aq. distill, ^vi; 
Empl. plumbi, fbiij ; 
01. olivar, Oi. 
Melt the plaster by a slow fire, and 
add the other articles. 

Compound Tar Ointment. 

R. — Picis liquid, 
Sevi, aa ftn ; 
Flor. sulph. !|i; 
01. olivar, ^ss. Mix. 

Elder Ointment. 

R. — Flor. sambuci, 

Adipis suill. aa R)i. 
Boil together for half an hour, and 
strain. 

Compound Sulphur Ointment. 

R. — Flor. sulphur, !|i; 
Nit. potash, gij ; 
Acid, benzoic. 
Acid, sulphur. 
01. bergamot, aa gi ; 
Adipis suillse, Ibss. Mix. 



Olea. Oils. — These are composed of oxygen, carbon, and 
hydrogen chiefly. They are generally marked by an unctuous 
feel, by their combustibility, and insolubility in water. They 
have been divided into fixed, and volatile or essential oils. The 
terms are sufficiently significant. The fixed give a permanently, 
greasy stain to paper, while the stain of most essential oils is 
removed by heat. 

Perfectly-fresh fixed oils are generally inodorous, and in this 
respect differ much from essential oils. They are also insipid, or 
nearly so, and lighter than water. Most of them have a yellow 
color, which is obliterated by charcoal. A red heat converts 
them into an illuminating gas, which is exceedingly brilliant. 
The combustion of this gas in the open air gives rise to water 
and carbonic acid. 

Although the fixed oils are not soluble in water, they can be 
suspended by the addition of mucilage of gum Arabic, the yolk 
of egg, sugar, &c. It is in this way we may prepare the well- 
known castor oil mixture, and give it a homogeneous appearance. 

The fixed oils are commonly prepared by powerful pressure of 
the seeds which contain them. This is done sometimes with, but 
frequently without, heat. The pale, cold-drawn castor oil, as 
its name imports, is procured without any elevation of tempe- 
rature. 



OILS — OPIUM. 611 

The volatile or essential oils are obtained by distillation of 
various parts of plants. They are quite soluble in alcohol, and 
hence the various spirits, essences, &c. 

Some of the oils are liable to undergo a change to a more solid 
state in the alimentary canal. Thus castor oil has given rise to 
hard, fatty formations in considerable quantity, and sometimes 
occasioning unpleasant symptoms. 

Some of the oils have been applied to the surface with success 
for the cure of shin diseases supposed to be induced by very 
minute insects. Castor oil, cod-liver oil, and lard oil have been 
so used for the cure of itch. The insects are said to perish when 
coated over with these oils, and the disease ceases necessarily. 
The application of castor oil for the cure of ringworm is a well- 
known and useful practice. The cathartic quality of several of 
the fixed oils is also well understood, as is also the carminative 
and antispasmodic properties of the essential oils. Some of 
these, rubbed in very small quantity along the spines of young 
infants, are more efficacious than when given by the mouth. I 
have tested this so often that it ceases to be a matter of doubt. 
Five drops of oil of cinnamon with a teaspoonful of sweet oil will 
often act thus. 

The New York Journal of Medicine and Surgery for Novem- 
ber, 1848, speaks very confidently of the successful treatment of 
the bites of rattlesnakes, by the administration of sweet oil in 
two-ounce doses every half hour, and the constant friction of the 
same oil to the bitten part. 

Opium. — This word is derived from the Greek, and signifies 
juice, referring, of course, to the juice of the poppy. Opium is 
therefore to ' be regarded as the concrete juice of the papaver 
somniferum, or white poppy. This plant is probably a native of 
Asia, where it is found growing as a common vegetable. It may 
be cultivated almost anywhere, and in this country it is exceed- 
ingly difficult to expel it from a garden spot. The small bulk of 
the seeds allows them to be carried by the wind to considerable 
distances, and thus, without the trouble of sowing, the plants are 
often very numerous. Like most other vegetables, this is im- 
proved very much by special care in its growth, and yet it is very 
easily cultivated. The seeds are sown very much as others of 
like size, and are put into the soil just as soon as it is in good 
order. The young plants, when only a handsbreadth high, are 
taken out of their bed and set in* rows a yard apart, the plants 
being six inches asunder. The usual care bestowed on other 
plants thus disposed of is here specially needed, as frequent 
watering, protection from the hot sun by boards, which are to be 
removed at twilight, &c. When the plants are near to the time 



612 CULTURE OF THE POPPY. 

of flowering, watering is very important, as it greatly improves 
the seed capsules and increases the opiate quality. 

The collection of the juice, which on being dried makes the 
opium, commences when the seed capsules are more than half 
grown, though some persons defer it to a later period. Just at 
sunset two or three longitudinal incisions are made into each 
capsule, great care being observed to avoid penetrating the in- 
terior cavity. The juice flows freely through the apertures so 
made : the process is, in fact, a kind of bleeding operation. The 
juice is very much paler than any variety of opium, and becomes 
dark by exposure to the air and by commixture with foreign 
particles of various kinds. It is collected very variously as to 
care and cleanliness, and this may well explain a part of the 
diversity met with in specimens of this important drug. Cer- 
tainly it could be accumulated in a state of purity, and then we 
should find pure opium. But if it be allowed to fall on the 
ground, in part, and on broken leaves and bits of decayed wood 
and manure, we should expect to see a product of a doubtful 
character in point of opiate strength, to say the least. These 
items assist in accounting for the vast disparity noticed in this 
article at different times. They may serve as a clue to explain 
an official announcement made by the inspector of drugs for 
the port of New York, viz., that from July, 1848, to May, 
1849, he had rejected three thousand three hundred pounds of 
opium as spurious ; and this quantity imported, too, from Smyrna, 
Marseilles, and London. 

The opium brought to this country is in spherical masses, 
varying from three to four inches in diameter, covered with poppy 
and tobacco leaves, varying in point of hardness with the weather. 
In warm, moist weather, it is adhesive, tenacious, and soft ; in 
cold weather it may be fractured into pieces, and can be pul- 
verized readily. 

Much interesting matter may be found touching the culture of 
the poppy in Coxes Medical Museum, vol. L, and in the ninth 
volume of the Quarterly Journal of Science. 

When a lump of opium is broken, the interior should present a 
pretty uniform brown color, and have a strong opiate smell as 
well as the marked opiate taste. It should look like a mass of a 
simple unmixed article. If it present a heterogeneous aspect, 
showing dirt, small pebbles, dung, pieces of leaves and sticks, 
having also a burnt odor, the inference is unavoidable that the 
article is not pure. There may be good opium in the mass, but 
there is much that is not opium ; hence the necessity of an in- 
terior inspection, which may compare very badly with a fine 
outside. 

We have named the bitter taste and peculiar smell as an opiate 



CHARACTERISTICS OF GOOD OPIUM. 613 

odor and taste. There is no other article, however bitter, that 
has the same kind of bitterness or the same peculiar smell. A 
little experience will convince any one of this, and he will find 
the importance of such knowledge sooner or later to be real. 

Besides the foreign matters seen in defective opium, I have 
known the masses to have small leaden balls in the centre, which 
were employed for the purpose of enlarging the weight at a time 
when opium sold for thirty dollars a pound, as it frequently did 
in the years 1810 and '11 in this country. These leaden ad- 
ditions were made to opium of valuable quality, but are some- 
times found in the most defective samples. 

Much as has been said of the superiority of opium from this 
or that place, I prefer my senses as the arbiter, rather than the 
reputation of Turkey or any foreign land. Come whence it may, 
if it lack the qualities and appearances named above, it should 
be rejected, for no sort of name can compensate for these. Let 
all medical men bear this in mind when about to purchase for 
their own use. Trust the assertion of no man, when your taste 
and smell and eyes can be so profitably employed as to settle the 
question of purity with certainty. 

I have seen excellent specimens of opium made in this country. 
One of these was of Ohio culture, and was equal to any that I 
have seen anywhere. The late Dr. Anthony, of Georgia, made 
excellent opium also, and in considerable quantity, during the last 
war with Great Britain. 

For a reason already named, physicians should always pul- 
verize their opium in the coldest weather, and the powder should 
be kept in well-stoppered bottles to exclude moisture. This is a 
matter of importance, since the ingress of moisture would tend 
to agglutinate the whole mass and unfit it for use as a powder. 

Opium contains all the appropriate elements of vegetable mat- 
ter, viz., carbon, oxygen, and hydrogen. In addition to these, 
the French chemists have shown that it contains morphia or mor- 
phine, narcotine, meconic acid, codeine, narceine, par amor phia, 
&c. &c. The most important of these is morphia, which exists 
in the opium in combination with meconic acid, constituting me- 
conate of morphia. 

Various expedients have been resorted to in order to separate 
the morphia from opium, and so to have it ready for any subse- 
quent combination. Its high value in practical medicine has in- 
duced the best operatives to put forth their efforts in order to 
present it in the best possible form. Liquid ammonia added to 
a watery solution of opium will soon separate the morphia by a 
quiet chemical agency. The process has generally been to form 
the opium into a paste with acetic acid and sufficient water. The 
whole is filtered through coarse paper, and ammonia is added in 



614 HOW MORPHIA IS OBTAINED. 

excess to the liquor which passes. The morphia is thus thrown 
down or precipitated, but is impure, and blended with the color- 
ing matter of opium, though found to contain great opiate power 
in small bulk. To detach the coloring matter and any other 
impurity, the manufacturers digest the mass in cold alcohol. 
The coloring matter is thus taken up, and the liquid, being 
filtered, furnishes a powder that is to be acted on by boiling 
alcohol, which takes up all the morphia. This alcoholic solution 
is set aside to allow of crystallization, which begins as soon as the 
temperature falls sufficiently low. The pure morphia is thus 
obtained in an imperfect crystalline state. 

The rationale of this process is quite simple, and very easily 
comprehended. In the first place an acetate of morphia is 
formed, which is decomposed by the liquid ammonia. The pro- 
ducts are acetate of ammonia, which is held in solution, and im- 
pure morphia, which falls to the bottom of the vessel. 

The process of Robiquet is a little different. He boils coarsely- 
pulverized opium with a little calcined magnesia, (two hundred 
grains to one pound of opium,) and soon a gray precipitate is 
visible. This is to be collected on a filter and well washed with 
cold water. The mass on the filter, after careful drying, is then 
boiled in strong alcohol, and the solution filtered while hot. As 
it cools down to the ordinary temperature, morphia is deposited. 
In this process the native meconate of morphia in the opium is 
decomposed by the magnesia, meconate of magnesia and morphia 
being produced as precipitates. When these are acted on by 
boiling alcohol the morphia only is dissolved, because the meco- 
nate of magnesia is not soluble in that fluid. 

Messrs. Henry and Plisson made morphia from opium without 
the use of alcohol. M. Blondeau did the same, as we learn from 
the Journal de Chimie Medicate for February, 1830. The pro- 
cess of fermentation was resorted to under the conviction that it 
would answer the end effectually. Two pounds and three-quarters 
of the best opium, cut into very small pieces, were placed in a 
vessel having a large mouth and furnished with a tight cover. 
Double the above weight of tepid water and three ounces of 
honey were poured on the opium, and two ounces of yeast added 
to the whole. After a careful mixture by stirring for a season 
the vessel was placed in a stove moderately heated, the cover 
having been properly adjusted. Under these circumstances fer- 
mentation commenced, and was allowed to go on until it ceased 
spontaneously. At the termination of this process it was dis- 
covered, as was anticipated, that the mixture had an alcoholic 
smell. It could not be otherwise, since the materials acted on 
were precisely such as must necessarily give rise to an alcoholic 
formation. The whole mass was next put into a tight bag and 



DENARCOTIZED OPIUM. 615 

well squeezed, fresh water being occasionally added. The liquid 
thus forced through the bag, when cold, was treated with excess 
of aqua ammonia, which caused a copious precipitate, which was 
well washed and dried. Subsequently the dried precipitate was 
pulverized, and water acidulated with muriatic acid was poured 
on it. The color of the whole is thus changed to yellowish-brown ; 
and after the acid has acted for several hours, the liquid is to be 
filtered and evaporated. The product is colored muriate of mor- 
phia, which can be made white by washing with pure water and 
boiling with animal charcoal. 

The pure muriate of morphia, so obtained, is an excellent pre- 
paration, and regarded by many foreign practitioners as the best 
of all the salts of morphia. When we desire to get the pure 
alkaloid, we detach it from this muriate by the decomposing 
power of aqua ammonia. The article in question is the basis of 
all the morphia salts, although careless apothecaries and physi- 
cians do not always make the distinction. I knew a gentleman 
who, although a practitioner, kept a large apothecary store in a 
western city, and who once ordered from a New York house a 
considerable quantity of morphia, intending at the time to pro- 
cure the sulphate of morphia, which was then the most popular 
salt. His order was faithfully put up, and the real morphia 
came. The difficulty then was to convert the alkaloid into one 
or more salts ; and after some consultation he was able to effect 
the object. The great insolubility of morphia is the grand ob- 
jection to its medical use. Indeed, Orfila was disposed to deny 
it a place among poisons, because of its insoluble, and, therefore, 
inert property. This morphia, however, very readily unites with 
acids, and hence we are enabled to form several good salts. 
We have only to add the base to an acid until the acid pro- 
perties are lost or neutralized, and then evaporate the solu- 
tion. Although pure morphia is insoluble in the manner above 
named, it has been ascertained that if it be well rubbed with 
olive oil, the opiate quality of the medicine is signally de- 
veloped. 

Before we speak particularly of the salts of morphia and 
their medicinal applications, it is proper to notice the denarcot- 
ized opium and the more common opiate preparations. The term 
denarcotized imports the abstraction of narcotine from opium ; 
this is effected by the solvent power of sulphuric ether, which 
dissolves all the narcotine and leaves the residue of the opium 
unchanged. On evaporation of the ethereal solution a crystal- 
line substance is left, which is quite distinct from morphia, and 
affirmed to be the most unpleasant part of opium. After its 
discoverer, it was first called the salt of Derosne, but is more 



616 LIQUID PREPARATIONS OF OPIUM. 

commonly called narcotine.* Opium thus freed of this noxious 
and offensive ingredient, is called denarcotized opium. For a 
while this new preparation had great popularity, and I believe 
it is still a valuable opiate. It appeared to have all the good, 
and none of the bad, properties of opium. The color is very 
little changed by the process, and the dose is the same with that 
of opium. 

The common laudanum, so generally in use, is known by the 
names tinetura opii and thebaic tincture, and is sometimes 
styled liquid laudanum. Various formulas are in use for pre- 
paring this tincture, but they are generally objectionable. I 
prefer one with even and exact weights and quantities, because 
the formula is more easily remembered and because the opiate 
strength of a dose can be more certainly known. I take an 
ounce of the best opium, well bruised, and digest it in a pint of 
the best brandy. Each fluidounce contains just thirty grains of 
opium. The dose is from twenty to sixty drops for an adult. 

Sydenham's liquid laudunum is a much stronger preparation. 
According to Dr. Thompson, it contains ten grains of opium in 
each fluidrachm ; but this is evidently a mistake. The following 
is the formula of Sydenham : — Take Spanish wine, a pint ; 
opium, two ounces ; saffron, one ounce ; powder of cinnamon and 
cloves, each a drachm. Expose the whole to a sand-bath heat 
for two or three days, and strain. It is easily calculated that 
each fluidrachm holds in solution seven and a half grains of 
opium, and not ten, as Dr. Thompson has said. This laudanum 
is plainly double the strength of the common laudanum, and of 
course the dose is diminished accordingly. Ten drops are equal, 
to twenty of the ordinary tincture. 

The black or Quaker § drop, so highly esteemed many years 
ago, and to this day, is an acetic tincture of opium. The old 
method of preparation is thus : — Take half a pound of good 
opium in slices, an ounce and a half of bruised nutmegs, and a 
half-ounce of saffron, and boil them in four pounds of verjuice, 
(or common vinegar,) and then add a quarter-pound of sugar and 
two tablespoonfuls of yeast. Let the mixture be put in a warm 
place to ferment for the space of six weeks. Then decant, filter, 
and bottle, adding a little sugar to each bottle. Some add, 
during ebullition, other aromatics, but it is not necessary. It is 
very obvious that an acetate of morphia is formed in the process, 
and hence the solution is sometimes called acetous tincture of 

* The London Lancet for Sept. 1857, notices the issue of vol, ii of Pareira's 
Materia Medica, 4th edition, greatly enlarged, in which notices are given of new 
alkaloids, &c. &c, such as cotarnine, a new product by decomposition of nar- 
cotine; opianine, opianic acid, papaverine, hellebrine, &c. &c, all save the last 
being related to opium. 



LIQUID PREPARATIONS OF OPIUM. 617 

morphia. The opiate strength is three times greater than that 
of common laudanum. Many have preferred this preparation to 
others because of its more uniform agreement with the digestive 
organs. 

My own opinion is in favor of making a solution of the pure 
acetate of morphia as we need it, and combining it as circum- 
stances may demand. We know more certainly what medicine 
we are employing, and the salt furnishes us everything to be de- 
sired from the black drop. It rarely constipates the bowels, or 
sickens the stomach, or induces itching of the skin, all of which 
follow the use of ordinary opiates. The dose of the acetate is 
about the sixth of a grain, which is equal to twenty-five drops of 
common laudanum. 

Rousseau's laudanum is fermented wine of opium, and made 
as follows : — Take twelve ounces of pure honey and three pounds 
of warm water, and put the vessel containing these in a warm 
place. When fermentation has begun, add four ounces of good 
opium previously diffused in twelve ounces of water. Let the 
whole ferment one month. Pour off the liquor, and evaporate 
to ten ounces. Filter, and add four and a half ounces of 
alcohol. 

The article as thus prepared is plainly a tincture of the acetate 
of morphia, the strength of which exceeds the common laudanum, 
but is liable to uncertainty. 

The Dublin Pharmacopoeia has an acetate of opium, made by 
macerating four ounces of opium, rubbed to a pulp in a pint of 
distilled vinegar, for the space of seven days. The mixture is to 
be shaken frequently, and finally filtered. It is simply acetate 
of morphia, and inferior to the black drop. The dose is from five 
to fifteen drops. It is consequently a good deal stronger than 
common laudanum. 

Battley's sedative liquor of opium is made thus : — Take dry 
opium, in powder, one part ; clean wash-sand, two parts. Mix, 
and moisten with water; introduce into a percolator, and pass 
distilled water at 65° or 70° through the whole till it runs off 
tasteless and colorless. Evaporate the liquor by steam or water 
bath to the consistence of a hard pill extract. Take of this 
hard extract three drachms, and of distilled water thirty ounces. 
Boil together for two minutes. Let it cool, filter, and then add 
rectified spirit, six ounces, and enough distilled water to make 
up nearly a quart. The dose is fifteen to twenty drops. Twenty 
drops are equal to thirty of best laudanum. 

McMunn's elixir of opium has been before the public for 
several years, and professes to have some special advantages over 
all other fluid preparations. It continues to be a secret nostrum, 
however, so that we cannot give its composition. Our experience 

40 



618 SALTS OF MORPHIA. 

in its use has not been very extensive, but it has not equalled our 
expectations by any means. Some persons are extravagant in 
its praise. They say it avoids all the unpleasant attendants of 
other opiate doses. 

The ammoniated tincture of opium is a worthless compound, 
and should be discarded. The ammonia precipitates the morphia, 
and renders the mixture comparatively inert. 

The camphorated tincture of opium, paregoric elixir, asth- 
matic elixir, are names given to an excellent medicine. A drachm 
of good opium is to be digested in a pint of brandy, adding a 
drachm of camphor and half a drachm of flowers of benxoin in 
order to make it. In a week or ten days it will be fit for use, 
after due filtration. One hundred and sixty drops of this tinc- 
ture are equal to twenty of common laudanum, or one grain of 
opium. 

The pectoral qualities of this tincture, and which led to the 
name asthmatic elixir, are due partly to the flowers of benzoin, 
which also improve the sensible qualities and make it more 
agreeable. 

We have already named an easy mode by which pure morphia 
can be converted into the various salts ; and enough has been 
said touching the acetate which enters black drop. 

The sulphate of morphia has been more largely employed in 
practice than any other preparation. It is a very pretty white 
crystalline article, and when in fine powder looks exceedingly 
like the sulphate of quinine. The surest mode of distinguishing 
a bottle of one salt from a bottle of the other is very simple. 
Put a particle of each on two watch-crystals, and on each let 
fall a drop of strong nitric acid. The morphia salt will be 
changed to a deep red, while that of a quinine will turn to a 
yellow. The taste of both salts being quite bitter, we cannot 
decide on that ground any more than by the external aspect. 
I have been in the habit of prescribing the sulphate of morphia 
thus : — 

R. — Sulph morph. grs. ij; 
Aq. menth. sji. 

The dose for an adult is a teaspoonful, and equal to thirty 
drops of common laudanum, or perhaps a little stronger. It may 
be conveniently administered in form of pill, because the bulk is 
very small. An eighth, or a sixth of a grain, or a quarter may 
be given in a pill, according to the urgency of the case. Dur- 
ing the prevalence of epidemic cholera in July, 1849, I had an 
attack which threatened to be quite severe ; and in less than two 
hours I swallowed pills of the sulphate of morphia equal to four 
grains of opium, combined with less than ten grains of calomel. 
The spasmodic pains and other symptoms were thus controlled. 



THERAPEUTIC POWER OF OPIATES. 619 

In a very severe gastric attack in the summer of 1844, in the 
city of Lexington, not very unlike the one just named, I took 
nearly the equivalent of six grains of opium in pills of the ace- 
tate of morphia in about two hours, and was cured. 

Dr. Edward Smith read before the Med. Society of London, in 
1856, a paper that merits notice, on the uses of very minute 
doses of morphia in certain chest diseases. W.e should think the 
disciples of infinitesimalism could hardly object to such minute 
portions, even of morphia and its salts. He began with one- 
sixty-fourth of a grain for a child four months old, repeating it 
six times in twenty-four hours. In adult cases, the dose was 
from one-twentieth to one-twelfth of a grain, to begin with, and 
repeated as in the other case. Supposing that the cough of 
pertussis, chronic bronchitis, and even phthisis often depended on 
spasmodic irritation, he aimed to control this and so give the pa- 
tient rest. At the same time the usual local appliances were re- 
sorted to. The writer does not specify the salt of morphia, but 
probably meant the sulphate. 

Before we dismiss the sulphate of morphia, it is proper to say 
that it has been and continues to be a subject of shameful adul- 
teration. The report of the inspector of drugs for the port of 
New York shows that amygdaline, an article very difficult of 
detection, is employed for this end. 

Nitrate of morphia was first made accidentally, being intended 
as a remedy for dysentery, and so employed with benefit. Dr. 
Hope, of Edinburgh, employed a solution of opium in nitric acid, 
in 1826, in this disease. There can be no doubt that the powerful 
action of this very energetic acid completely detached the mor- 
phia and gave rise to the nitrate. And I have no doubt of its 
utility after free evacuations had left the bowels in a very relaxed 
state, though it could not have been a safe article in the early 
stage. 

Citrate of morphia has had its admirers. At least two modes 
of preparation have been named. Four ounces of good opium 
and two of crystallized citric acid are well rubbed in a porcelain 
mortar, adding a pint of pure water. Macerate for twenty-four 
hours, and filter. The mixture is a citrate of morphia, but con- 
tains narcotine. Some prepare it by the addition of rectified 
spirits. Thus : — 

Take of hard opium, three ounces; 

Citric acid, an ounce and a half ; 
Boiling water, fifteen ounces ; 
Rectified spirit, thirty-five ounces. 

Pour the boiling water on the opium, and macerate for twenty- 
four hours. Add the spirit, and again macerate for fourteen 
days, and strain. This preparation is said to agree well with the 



620 THEKAPEUTIC POWER OF OPIATES. 

stomach when other opiates do not. It is stronger than the 
ordinary tincture of opium. In this solution narcotine is also 
present. 

The following formula avoids narcotine completely, and gives 
a very neat medicine. Sixteen grains of pure morphia and 
eight grains of cristallized citric acid are to be dissolved in an 
ounce of water, and just enough tincture of cochineal added to 
give a light-pink tinge. The dose is from five to twenty-five 
drops. I made this solution some years ago for my own use, and 
found it a very pleasant opiate. 

All the salts of morphia named above are decomposed by solu- 
tions of potash, soda, or ammonia. The muriate is the most 
soluble in water, and hence supposed to be the most efficient by 
some practitioners. 

What is called the " morphia suppository" has been intro- 
duced into the Samaritan Hospital, having been previously used 
with great advantage by Prof. Simpson, of Edinburgh. 

R. — Acet. morph. six grains; 
Sacch. lactis, one drachm ; 
Cerat. simp, half a drachm. 
Mix, and divide into twelve suppositories ; which are then to be coated by 
dipping into a mixture of white wax, one part, and lard plaster, two parts, 
melted together. Put a needle into the apex of the suppository, dip into the 
melted wax and lard, and then instantly into cold water to harden it. The shape 
is conical. 

These suppositories are very useful after operations on the 
vagina, rectum, uterus, perineum, &c. Mr. Coulsonhas employed 
them in several lithotrity cases, with decided benefit. They are 
an excellent substitute for the internal use of opiates. 

Opium and all its salts and fluid preparations have been 
placed at the head of anodynes, sedatives, and narcotics ; these 
terms being employed synonymously by most persons in the pro- 
fession. Although many attempts have been made to explain 
the actual mode of operation, we are yet very much in the dark 
touching the whole subject. That the first or primary effect of 
small doses is always stimulant, is generally conceded. The 
gradual augmentation of the dose in the same person, on the 
next day, develops a like action. This is manifest in the accele- 
ration of pulse, the mental exhilaration, the slight headache, the 
elevated temperature of the skin. If the dose be not repeated, a pe- 
culiarly quiescent state ensues ; the pulse, though fuller, is slower ; 
the skin is not so hot, and is moist ; the mind is tranquil, the sensa- 
tion of pain is mitigated or obliterated, and presently a sense of 
comparative feebleness is realized. If a dose be given just 
sufficient to procure sound sleep, the man awakes refreshed. If 
the dose be disproportioned to the actual state of the nervous 
system, he is troubled with dreams, his sleep is disturbed, and the 



USES OF OPIUM. 621 

whole system is the worse for the medicine. These results may 
follow a dose too small or too large; and hence the common 
phrases, a right dose, a wrong dose, meaning simply that the 
quantity administered was, or was not, exactly adapted to the 
state of the system. 

The great therapeutic principle here involved has "been very 
forcibly illustrated by Smith, in his late work on Parturition. 
" Some striking differences must be made respecting the adminis- 
tration of opium under different circumstances, particularly in 
puerperal convulsions. If a dose of opium be given in this dis- 
ease in a full state of the circulation before bleeding, there is an 
aggravation of the disorder ; while, if it be given in the same 
convulsions in an anaemic subject, or after excessive depletion, it 
is of great service. If in a case of convulsions opium be given 
at the commencement, it is dangerous in its effects ; but the same 
medicine is frequently valuable in the advanced stage of the same 
case when the vascular system has been powerfully depleted. 
Thus it would appear that while opium in convulsions with a full 
state of the circulation is a stimulant to the spinal marrow, in 
convulsions with anaemia it is distinctly sedative." I have long 
been in the habit of teaching substantially the same doctrine to 
my classes in Transylvania University ; and my usual phrase- 
ology was simply this : — Opium will prove a stimulant or sedative, 
according to the state of the system at the time of its exhibition. 

One of the simplest uses of opium has been merely to lock up 
the system, as the phrase is, for several hours, in order to extin- 
guish pain. This has been effected beneficially in that painful 
but not dangerous complaint the toothache. I have found it sig- 
nally successful in my own person as well as in the persons of 
others. A fit of toothache can often be deferred in this way for 
six months or a year. My plan has been to swallow a large tea- 
spoonful when the pain became very severe, and to go to bed. 
The effect has been to quiet the local disturbance, and to give a 
profound sleep for six or eight hours, and to prevent a recurrence 
for a long while. A similar practice was adopted many years 
ago to prevent a paroxysm of an intermittent, to save from the 
chill and its consequences. An hour prior to the dreaded hour 
of attack, two, three, or even four grains of opium were admi- 
nistered in a single dose. The system was put into a state of 
perfect quietude, and remained thus a long while ; even a longer 
period than all the stages would probably have occupied had the 
dose not operated to keep them off. 

This locking-up practice may sometimes prove injurious, but I 
have never realized any unpleasant consequences from it, although 
I have often resorted to it. If there be no obvious determina- 
tion to the lungs or brain, there can be little hazard in the ex- 



622 STIMULANT ACTION OF OPIUM. 

hibition. When it is employed to prevent the cold stage of an 
intermittent, the salutary action is generally improved by immer- 
sion of the feet in hot water, and the use of sinapisms to the 
ankles, before the patient falls asleep. Such was the custom of 
Sydenham, and I know it to be a wise course. He supposed the 
opium acted in all such cases by its stimulant power ; but that is 
not quite certain, since Lempriere, Lind, and some other physi- 
cians of high character gave opium by preference in the hot 
stage, because of its tendency to augment the discharge by the 
skin. They speak of the remedy so applied with great confidence, 
and doubtless it may answer in persons of phlegmatic and melan- 
cholic temperament, while it would seem to be unfit for the 
plethoric. Lind affirms that this use of opium considerably 
abbreviates the hot stage, while it also lengthens the period of 
intermission, and so prepares the way for the use of the bark. 

That opium stimulates when given after the manner of Lem- 
priere would seem quite plain from the augmented action of the 
cuticular vessels ; but it is problematical whether its curative 
agency after all can be on the same therapeutic principle in the 
two stages named. We doubt it. 

Before we dismiss the consideration of the stimulant character 
of opium it may be well to cite some additional facts. If a 
watery solution of opium be applied to the eye or urethra, or 
any tender, irritable surface, it gives pain more or less severe, 
and displays a marked stimulation. In the sot shops of Con- 
stantinople, opium is prepared with rich syrups and other confec- 
tioneries, and divided into cakes varying from ten to one 
hundred grains. The sombre Turks sit in rows, and the waiters 
pass along, throwing a cake into each open mouth. This opera- 
tion is repeated at suitable intervals, as the excitement is observed 
to rise in each man, or until obvious signs of incipient intoxica- 
tion are visible. Soon the fellows become delirious, and the 
raving Turks are now most unceremoniously pitched out of the 
front door just as the sot is kicked from the groggery when he 
can drink no more or his cash is exhausted. These shops are 
visited by the poorer classes, the more wealthy indulging them- 
selves at their own dwellings. Many of these places are repre- 
sented as the most miserable and wretched dens imaginable. 
The Reverend Mr. Squire, of the Church Missionary Society, 
says of them : — " Never, perhaps, was there a nearer approach to 
hell upon earth than within the precincts of these vile hovels, 
where gaming is likewise carried on to a great extent." At one 
place or another in China all classes in the community are ad- 
dicted to this practice. 

In these cases the regular repetition of the opiate keeps up 
and gradually augments the stimulant action, which continues to 



ACTION OF OPIUM. 623 

rise while the dose is administered. If these men could be in- 
spected a few hours afterward, their symptoms would present 
the clearest tokens of indirect debility as the product of indirect 
sedation. Here are very opposite states of the system as related 
to the effects of opium. And the philosophy of the cases is not 
unlike that discoverable in the use of opium at different periods 
of the day. Taken early in the morning and on an empty sto- 
mach, it will generally induce a very excited state of the system, 
but no sleep. The same dose swallowed after sundown causes 
but little excitement of the nervous system, and sleep is soon 
obtained. 

Some physicians have supposed that opium acts through the 
medium of the blood, and independently of the nervous system. 
Fontana was inclined to this opinion, from observing that opium 
applied to the brain or the nerves of a frog produced no effect ; 
that the heart detached from the body and placed in a solution 
of opium is not deprived of its irritability sooner than when put 
into water ; but that when opium is injected into the veins death 
instantly followed. 

Others believed that opium acted chiefly on the muscular 
fibre, destroying its contractility. Some have ascribed all its 
effects to mere sympathy, which is just no solution at all, in any 
sense. Far more rational is it to regard the medicine as acting 
on the great centre of the system, affecting all the filaments of 
the central organ, and thence, by nervous communication, ope- 
rating on all other parts. Some have contended that it acts 
only by absorption into the mass of blood. This has been in- 
ferred from the length of time required to affect the general 
system. This may call for one or more hours, although the 
opium is in contact with the nervous structure of the stomach 
indirectly. The rapid effects of opium injected into the veins, 
and the speedy anodyne influence of the mother's milk on her 
infant after she has been put under opiate influence, are sup- 
posed to indicate the agency through the medium of the circu- 
lation. 

The practical applications of opiates are exceedingly numerous. 
Dr. Thompson proposes opium as a good addition to calomel in 
obstinate tertians that have resisted the ordinary treatment. A 
pill of one grain of each article, taken at bedtime for a week, 
has happily prepared the way for the successful employment of 
the bark. 

There are cases frequently occurring in which we fear to give 
opium because we dread the presence of more arterial excitement 
than seems to be consistent with its administration. In circum- 
stances like these the addition of a little ipecacuanha will exert 
a happy modification, while opium alone might be inadmissible. 



624 USES OF OPIUM. 

Three or five grains, with one or two of opium, will compose the 
system, and carry off undue excitement by a copious and salutary 
perspiration. This combination is often useful as a means of 
subduing wakefulness, subsultus tendinum, and diarrhoea, that 
are sometimes troublesome features of typhus fevers. More 
than a hundred years ago, Dr. Gilchrist strongly recommended 
the use of opium very early in inflammatory fevers, to prevent 
delirium ; and his practice led to the use of wine and opium 
jointly in fevers with inflammatory symptoms. 

Delirium is very differently affected by opiates. If it be 
accompanied by flushing of the face, impatience of light and 
sound, throbbing of the temples, &c, opium will uniformly in- 
crease the difficulty. On the other hand, the low muttering 
delirium of debility very often yields to opiates, and especially if 
camphor be added in proportion of a grain or two to the opiate 
dose. 

Almost all acute affections of the chest are relieved by full 
doses of opium after free or appropriate depletion. Especially 
do good effects follow the exhibition of opiates, if modified by a 
small amount of tartar emetic or ipecacuanha. Cullen's practice 
in acute inflammation of the substance of the lungs [pneumonia) 
was to bleed freely, and then to give a full dose of opium, to 
tranquilize generally, but particulary to relieve the cough and 
irritable state of the lungs. This practice was very successful 
formerly, and has been so in recent times in innumerable in- 
stances. 

The peripneumonia notha, as it was formerly called, of old 
persons, has often been signally relieved by a grain of opium 
and two grains of squill, given every three or four hours. It 
acted by allaying irritation and promoting expectoration. When 
a similar disease affects younger persons, in the shape of bron- 
chitis, the opiate must be preceded by moderate venesection or 
local bleeding from the chest. After this preparation the opiate 
exerts a happy influence through the pneumogastric nerves, 
enabling the patient to make fuller and more perfect inspirations, 
the expectoration being already greatly relieved. 

After general and local bleeding acute ophthalmia is often 
much relieved by opium, and especially by a watery solution of 
the denarcotized opium in the proportion of three grains to an 
ounce of water. Sometimes the dropping of a little common 
laudanum in the eye has been serviceable by its counter-irritant, 
and ultimately by its sedative influence. 

In acute rheumatism not a few persons make opiates their 
sheet-anchor, even to the exclusion of depletion ; while some are 
equally partial to them after venesection or leeching. But if 
the disease be really acute, it will not answer to rely merely and 



USES OF OPIUM. 625 

exclusively on the sedative and anodyne qualities of any sort of 
opiate. There is too much danger hanging over the heart in such 
cases to allow of this sort of treatment. Were the opium combined 
with ipecacuanha and calomel, or blue mass, we should be less 
reluctant to assent to the propriety of the practice. Dover s 
poivder is better than opium alone ; and if the relative quantity 
of the emetic were increased, so much the better. This powder, 
as we said elsewhere, is composed of one grain of ipecacuanha, 
one of opium, and eight of sulphate of potash, well incorporated 
by trituration ; and its usual dose is from ten to fifteen grains. 
The best period for administration is at bedtime ; and if warm 
drinks be taken in small quantity soon after, the effect on the 
skin will be more apparent. It is diaphoretic, and sedative or 
anodyne. 

The irritation of calculous matter in the pelvis of the kidneys 
and ureters is often exceedingly distressing. Early in the attack, 
besides the use of the warm bath and bleeding, which is gene- 
rally needful, a full dose of opium or a salt of morphia should be 
administered, and repeated in an hour, or in a half-hour if relief 
be not sooner procured. The pain and severe irritation of biliary 
calculi may be promptly relieved by a similar course of treatment. 
Should the stomach be so irritable in these cases as to preclude 
the administration in that way, let a resort be had to injections ; 
or it would be very well to make a blister speedily, on the abdo- 
men, near to the course of the urethra, or over the liver, by firing 
a piece of linen soaked in pure alcohol, removing the cuticle, and 
putting on the raw surface a half-grain of the acetate of morphia, 
or even a grain, and repeating in an hour or sooner. Thus all 
danger of irritation of the stomach would be avoided. 

In gonorrJioea, with severe chordee and painful micturition, no 
remedy is more salutary than opium, if bleeding and purging 
be first resorted to. A grain of opium and two of calomel, re- 
peated every two hours, will not only mitigate the pain, but the 
effect will be, very perceptibly, antiphlogistic. In such cases Dr. 
Hamilton, of Norfolk, in England, gave two grains of opium 
with six of calomel at a dose, repeated every eight hours. It is 
not a safe practice in the early stage of gonorrhoea unless pre- 
ceded by bleeding and purging. 

Dr. Lane reports very marked success with opium in the 
reduction of hernia that had resisted all ordinary means. In 
one case, sixteen grains of opium and thirty-two of calomel were 
administered, besides some laudanum, before the result was ac- 
complished. It is supposed that the opium operated by allaying 
local irritation, and also by its anaesthetic action. (See Ranking, 
No. 10, p. 134.) 

Mr. Skey, surgeon to Bartholomew's Hospital, reports a very 



626 USES OF OPIUM; 

interesting case of the cure of an old ulcer on the calf of the leg, 
and as large as one's open hand. It had resisted all the efforts 
of surgeons for seventeen years, and was regarded a hopeless 
case. The patient was put on the use of half a grain of opium 
night and morning, the limb being strapped and rolled as usual. 
In three days the color of the ulcer was manifestly improved ; 
and in two months its dimensions were reduced to the size of half 
a crown, and the general health also improved. No other means 
besides the opium were resorted to by Mr. S. Did not this act 
chiefly by allaying mental and physical irritation ? (See Braith- 
waite, part xx.) 

A good deal of diversity of opinion has obtained in the profes- 
sion touching the use of opium in dysentery. Sydenham, Lind, 
and many others, have advocated the practice in decided terms ; 
while Pringle, Cleghorn, Blane, and others, as strenuously op- 
posed it. Some gentle purgatives, as Epsom salt and castor oil, 
followed with full doses of laudanum, and suitable diet, made the 
common treatment in Great Britain for many years, and it was 
successful. Such was substantially the practice of the celebrated 
Heberden. Nor do I doubt the propriety and great usefulness of 
opium in very many cases of this disease subsequently to the re- 
duction of high morbid action, whether general or local. If 
bleeding be deemed inadmissible, I should prefer the use of 
emeto-cathartics, consisting of calomel and ipecacuanha, so as to 
induce free vomiting and purging; and at bedtime the laudanum 
or other opiate should be given by the rectum. Powders made 
of calomel and ipecacuanha, each five grains, and given every 
half hour until three or four are administered, will usually suffice. 
Sixty or eighty drops of laudanum, given by injection, will quiet 
the system, and the disease will thus be arrested, provided atten- 
tion be paid to the use of light emollient diet. 

Much has been said of the use of opiates in the management 
of pulmonary consumption, but they can only palliate. And 
here it is proper to say that the less medicine of any kind the 
better for the patient. If he can take cod-liver oil without dis- 
relish, let him persist in its use. But the practice of dosing with 
this panacea and the other, while it does not meet the case at all, 
seriously impairs the tone of the stomach and destroys the appe- 
tite. And when this state is fully reached, the man is near the 
end of his journey. I would not give him an opiate by the 
mouth for any purpose whatever ; nor is it necessary. Perhaps 
his chest is painful, or he has occasional stricture, or both, which 
may justify the application of a blister. Let the surface be 
kept running a while, and now and then apply a half-grain or 
more of a salt of morphia to the raw surface, and you give the 
wished-for relief. And if the state of the chest should not seem 



USES OF OPIUM. 627 

to call for a blister so large, apply one of the size of a dollar, 
and there let the salt of morphia be placed. Or give laudanum 
by injection if an anodyne must be administered, but do not de- 
range the digestive organs by exhibiting opiates by the mouth. 

The following linctus, which owes its power chiefly to the 
opiate ingredient, is affirmed to be admirably suited to a large 
majority of coughs, and may be worth notice. It is in common 
use in St. Bartholomew's Hospital: — 

R. — Confect. ros. canin, ^ij ; 
Tragac. pulv. ^i ; 
Syr. papaver, gvi; 
Acet. scill. gvi; 
Acid. acet. gtt. xx ; 
Aquse fervent, £xi. 
tt|. — Dose, one to three tea-spoonfuls at bedtime. 

Opium in every form has been profusely administered to 
patients laboring under tetanus. The well-known antispasmodic 
property of this medicine seemed to adapt it precisely to such a 
disease as this, and we dare not assert that the use of it has not 
been successful. We do affirm, however, that in hundreds of 
cases it has not appeared to be at all beneficial, though given in 
very large quantities. We have the record of a case in vol. i. of 
Medical Commentaries, in which fifteen hundred grains of opium 
were exhibited in seventeen days, with success ; and another 
showing that the patient took twenty ounces of laudanum in 
twenty-four hours, to no good purpose. I have given it as fast as 
it was possible, and in large doses, day after clay, not only by 
the mouth, but in form of ointment as strong as powder of opium 
could make it, and that rubbed frequently along the spine, and 
this associated with wine and brandy and kindred means, and no 
good appeared to result. The force of the radial artery was not 
augmented in the least, and all the stimulant power seemed to go 
into the muscles to augment their rigidity. 

I am inclined to think that the best opiate practice in tetanus 
would be to blister the whole length of the spine, and to keep it 
under the constant influence of a salt of morphia and extract of 
belladonna, alternated on the raw, decuticulated surface. I 
infer this from one or two facts that were published in a foreign 
journal not long since, and think the suggestions worth a trial. 

We do not very often hear of the use of opium in menorrhagia, 
although laudanum alone, or with sugar of lead, has been em- 
ployed successfully in uterine hemorrhage, strictly so called. 
We have strong testimony in Lettsom's works, vol. iii. p. 104, in 
favor of large doses of opium in this form of disease, and the 
authority is sufficiently credible at least to claim our attention. 
Dr. L. asserts that for thirty years it was his custom, when called 



628 OPIUM IN ASIATIC CHOLERA. 

to a patient made extremely feeble by profuse discharges of 
blood, to give an injection per vaginum, of five grains of opium 
dissolved in two or three ounces of water, and to repeat every 
three or four hours until the flow ceased. He adds that notwith- 
standing the well-known success of this practice, he is not aware 
that any other physician has tried it. There can be no doubt, 
we think, that this very vigorous opiate treatment operated 
chiefly on the nervous system, inducing a state of universal 
quietude, while at the same time the direct stimulant force of the 
medicine induced the. closure of the bleeding vessels. 

The fourth volume of Medical Facts, page 120, announces that 
Dr. Whytt and Mr. Copland treated monorrhagia by injections 
at bedtime of from sixty to eighty drops of laudanum and four 
ounces of water, and found them to succeed much better than 
any of the ordinary astringents. 

But we must not omit to notice the importance of opium as a 
remedy for Asiatic cholera. We have noticed this subject, though 
briefly, in another place, in connection with the calomel practice. 
That opium alone, or with calomel, is competent to arrest that 
terrible disease, has certainly been shown in very many instances. 
The popular medical opinion in this respect is abundantly obvi- 
ous. Wherever we turn our eye to peruse the notices of success- 
ful treatment, whatever may be in the prescription, opium is 
never absent. Very many of the compound mixtures employed 
during the late epidemic in various parts of the country have 
come under my notice, and some form of opium occupies a con- 
spicuous place in all. 

After a careful survey of this subject, I have come to the con- 
clusion that the best treatment, not only during the premonitory 
stage, but when the rice-water discharges begin to abound, Js the 
opiate medication in some shape or other. Often it is better to 
prepare the way by a mustard emetic, and then to administer 
from one to five grains of opium alone, or with from five to ten 
grains of calomel, and to repeat in an hour if necessary. This 
and perfect rest, with the usual external appliances, constituted 
the safest and best practices, so far as opium was concerned. 

I know that some physicians gave six, eight, ten, and twelve 
grains at a dose, and sometimes with great success. But I can- 
not resist the conviction that such doses have sometimes killed 
the patient by a fatal narcotism ; and I make the remark as the 
result of some observation and study of this very point. And I 
think it possible that some persons, in the hurry and tumult of 
the terrible scourge, have been consigned to the narrow house 
not actually dead, but so deeply narcotized that all the usual 
phenomena of life were suspended, so that vitality appeared to 
be extinct. It is much wiser to give opium in smaller doses, 



EXTERNAL USES OF OPIUM. 629 

and to repeat frequently, than to exhibit at once ten or twelve 
grains. 

The largest dose of opium on record, so far as I know, for 
any purpose, is forty grains. In vol. viii. of Duncan s Medical 
Commentaries, it is said that this dose was given by Dr. Binns, 
of Liverpool, in 1798, in a case of insanity. In four hours after 
a scruple was given, with the effect of complete restoration. 

The addition of some form of opium to all our pectoral mix- 
tures or cough medicines is further evidence of its high popu- 
larity. Whatever be the nostrum or panacea that is heralded in 
the newspapers as an infallible and speedy cure for a cough or a 
bad cold, it will be found almost invariably to contain this medi- 
cine in one shape or another. Even those recommended with 
the peculiar specification that there is not in them a particle of 
opium, do, after all this proclamation, contain laudanum, or pare- 
goric elixir, or a salt of morphia. And, in truth, the irritation 
of a severe cough often demands the use of opium ; and it will 
be salutary if preceded by an emetic, or the lancet, or by local 
depletion. Sometimes, too, it may be beneficial even if not so 
preceded, provided the mixture act freely on the skin, or by the 
kidneys. These are redeeming qualities that save the system 
from the pernicious influence of opium. 

It is not necessary to enumerate the various external uses of 
opium. These are almost without number, and are often of great 
value. As an addition to eye-washes or collyria, or as entering 
into the formation of poultices and liniments for the relief of 
painful and indurated tumors, we frequently find opium to be a 
very useful external remedy. We may mention here, particu- 
larly, the signal relief sometimes afforded to women suffering 
severely from after-pains, by the application of anodyne or opiate 
liniments or cerates to the enlarged mammary glands. A two- 
fold end is attained by this expedient, and the measure is vastly 
preferable to the common practice of giving from twenty to forty 
drops of laudanum. The soft cerate or bland and soothing lini- 
ment not only arrests the pains of the uterine region by sympa- 
thetic action, but the breasts, more or less indurated or tense, or 
both, are tranquilized and softened. To make the cerate, we add 
from a half-drachm to a whole drachm of finely-powdered opium 
to half an ounce of simple cerate, which may be softened yet 
more by the addition of a little sweet oil. Rub the whole inti- 
mately, and the opiate cerate is formed. The anodyne liniment 
can be made more speedily by mixing sweet oil and laudanum, 
equal parts, or two of laudanum with four of oil, and shaking 
the bottle frequently. The cerate or liniment should be applied 
on soft linen or flannel twice or thrice a day. 

A novel use of opium to allay the irritation of catarrh is fur- 



630 OPIATES IMPROPER FOR INFANTS. 

nished by Dr. Lombard, of Geneva. He directs a metallic plate 
to be heated over a spirit-lamp, a few grains of powdered opium 
to be sprinkled on it, over which the patient is to hold his head 
so as to inhale the fumes. He must make efforts to have full in- 
halations of the anodyne vapor. The distressing sense of weight 
and pain in the frontal sinuses is speedily annulled, and the 
patient can sleep comfortably. If fever call for attention, a tea- 
spoonful of sweet spirits of nitre may be given every hour or 
two. 

Before we speak of the vice of opium eating and the poisonous 
action of opium, together with the treatment proper for such 
poison, it is desirable to premise a few remarks that cannot be so 
fitly introduced anywhere else. 

No practitioner should prescribe any preparation of opium for 
a stranger until inquiries are made in order to ascertain whether 
or no he has been accustomed to the medicine, and what doses he 
has employed on former occasions. It is obvious that such know- 
ledge is essential to the right exhibition of opiate medicine, and 
should never be overlooked. Suppose the person be an opium 
eater, and you know not the fact, and now you are consulted 
touching some very painful affection demanding relief by some 
means fitted to abate or control pain. Would a dose of opium 
touch such a case ? I think not. But the man will die if he be 
not soon relieved. His pains are insupportable. Presently the 
truth comes out, and you learn that he has long been in the habit 
of eating, at one bite, five times as much opium as you ever gave 
to any patient at once. What will your opium do in such a 
case ? You may give it, but there is nothing in his stomach or 
system on which it can act. Your ingenuity is taxed, and a sub- 
stitute is found, and possibly you save your patient. The import- 
ance of the inquiry we have suggested is therefore manifest. 

But I desire to express my opinion in reference to the adminis- 
tration of opiates to infants; and I mean to do so emphatically. 
I take the position that an infant under a year old never requires 
this medicine internally, if at all. It should never be given to 
such tender subjects on any pretext whatever : first, because it 
is not necessary to their health or comfort ; and, second, because 
it is truly a poison to their tender tissues. Children without 
number have had their physical frames ruined by the perpetual 
exhibition of Godfrey's cordial and the like, to relieve lazy nurses 
from the task of amusing and quieting the helpless creatures con- 
fided to their care. And if the secret history of more than half 
the cases of dyspepsia that prove so troublesome in after life 
could be written out, one of the darkest pages would reveal the 
fact of the gradual but certain poisoning of the mucous coat of 
the stomach in this way. The foundation is thus laid, deep and 



OPIUM EATING. 631 

broad, of innumerable ills that make the child and the youth and 
the full-grown man a miserable invalid. The babe cannot sleep, 
and the poison is at hand to force what nature is not ready for. 
There is some flatulence in the course of the alimentary canal, 
and the infant cries almost incessantly. At any time that would 
be unwelcome ; but at midnight it is insufferable, and the dose is 
plied again and again till the cries are subdued. And yet all 
this and more could be controlled by a warm bath, or by frictions 
to the spine with the hand, or a soft flannel, or a mixture of sweet 
oil and a few drops of the oil of cinnamon ; or, at all events, by 
throwing up the rectum an ounce or two of the milk of assa- 
fcetida, and repeating this several times until the desired end is 
reached. 

It is bad enough to acquire the habit of taking opiates in adult 
life, without forcing the terrible habit in early infancy. There 
can be no doubt that many persons, under the plea of using 
opiates to allay pain, cherish the habit and fix it almost indelibly. 
Much more opium is thus consumed than the actual state of dis- 
ease calls for, and this merely because the article is more and 
more relished every day as the effect of habit. It is on this 
principle that we can account for the facts recorded of women 
affected with cancer consuming three pints of laudanum daily, 
besides solid opium taken at intervals. It is hardly possible 
that the worst cancer could require so large an amount of a 
narcotic medicine ; and we are forced to the conclusion that the 
love of the brandy in the tincture and the relish for the opium 
acquired by long use constitute the most fitting solution of the 
problem. There is a case on record of a woman who swallowed 
two hundred pounds of opium in the course of thirty-three 
years. 

These remarks bring us to the consideration of what has been 
very properly styled the vice of opium eating. A vice it is, 
indeed, and terrible are its consequences. We earnestly entreat 
all persons who have doubts on this point, and who are possibly 
themselves in danger, to peruse a small volume entitled Confes- 
sions of an Opium-Eater. The statements, written by the suf- 
ferer himself, are so truly graphic and so exquisitely to the life, 
that they force the most skeptical to admit that they are sober 
realities. Not a doubt can be entertained in relation to the 
entire history by any one who has witnessed a case of long-con- 
tinued and excessive opium eating. The reality is so terrible 
that no array of words can make the description fully true to 
life. Language is too barren for such a task. It is a vice that 
hurls from the loftiest elevation the most towering intellect, dis- 
sipates into thin vapor the solid lore of ages, transforms the 
giant into the veriest pigmy, sinks lower than the brute the 



632 EFFECTS OF THE VICE. 

being made in the image of his God. And thus works this 
horrid vice. 

The author of the Confessions declares that he took one hun- 
dred and thirty grains of opium per day, not by accident or mis- 
take, but as a habit. But large and monstrous as this may seem 
to be, I have known the vice to be carried further. I knew a 
man — a physician, a professor, an author of renown, who finally 
perished on the altar of opium — who took one hundred and sixty 
grains a day, and was not satisfied. But even this was under 
the maximum, and possibly we may never find it. Russell tells 
of a Turk who was in the habit of swallowing daily one hundred 
and eighty grains, and even increased the dose. 

Let it not be imagined that we are to restrict our censures 
touching this vice to one sex. The evil is far from being con- 
fined to males, as many can testify who have long kept retail 
apothecary shops in large cities. At twilight, and sufficiently 
disguised to prevent recognition, ladies of highly respectable 
families have been known to sally forth to procure the wished- 
for stimulus. They obtain it, not by the ounce, but in the bottle 
that will hold a pint at least, and thus prevent too frequent re- 
petition of their visits. To what extent this pernicious habit 
obtains among the softer sex I cannot venture to say. There is 
good reason, however, to fear that it is not retrograding. 

It has been said that some persons who eat opium appear to 
enjoy good health. But the health is not real nor permanent, 
and is not a matter of enjoyment at all. If there be any joy in 
the case it is sadly mixed, so as to make it very difficult to say 
which preponderates, the bitter or the sweet. We know that a 
constitution naturally vigorous may sustain many and very se- 
vere shocks, but the hardest and the stoutest cannot always 
brave the storm. The native excitability will wear out, the 
stamina cease to have an energy-imparting power, and the me- 
lancholy end will at length come. 

All opium eaters acquire a deadly pale or sallow aspect, with 
tokens of emaciation, sooner or later. The evacuations from the 
bowels cease to be regular, until at length there is scarcely an 
inclination for days together, and even for weeks. The tone of 
the stomach is more and more enfeebled, the appetite fails, is ex- 
ceedingly capricious, hemorrhoidal tumors harass, the neck of 
the bladder becomes highly irritable, urination is painful, and the 
discharge very small. It requires but a slight inspection to de- 
tect the fact that the man is wretched, and the more so from the 
failure of all his efforts to make his friends think otherwise. If 
you hint your suspicion of the cause, his denial is as firm and 
fixed as his broken-down constitution will permit. An occasional 
reflection begets a momentary apprehension for his safety, and 



CAN OPIUM EATERS BE SAVED? 633 

the drug is laid aside for a brief season, to give place to 
all the modes of using tobacco, to brandy, wine, and every 
kindred stimulus, each in its turn, and all to excess, until it is 
manifest to those around that the man is becoming a sot. He 
suspects the reality, and feels it too, and now makes another 
turn in the winding lane of his erratic life ; but it lands him in 
the vortex of his former habit. 

An individual of my acquaintance was addicted to these frightful 
alternations in the phases of this vice for more than twenty years. 
The advance, during the first eight or twelve years, was so gradual 
that many of his acquaintances failed to detect it. In later years 
it made sad havoc with his frame, till, at length, the being of fifty, 
(for he had ceased to be a man in the real sense of the term,) 
deeply imprinted with all the insignia of threescore years and. 
ten, fell into a premature grave. For several years prior to his 
death he was rarely known to take a regular meal. He ate by 
fits and starts ; was peevish and fretful to the last degree, and, 
although never conspicuous for decision of character, lost en- 
tirely what of firmness he had ever possessed ; was vacillating as 
the weathercock ; his vital forces wasted to a point, and a mere 
speck of animated existence left as the sad memento of what he 
had been. On the last day of his sad career he snatched the 
brandy glass as with a death gripe, carried it to his lips by an 
extra effort, drank it off unmixed, and then, like a driveling 
idiot, sobbed and cried for more. 

For several months before the decease of this individual took 
place, his skin looked more like old parchment than anything 
else, and had, in fact, little more about it to indicate vitality ; 
his stomach and bowels lost all their sensibility ; his pulse was 
like a thread, and his mind had well-nigh ceased to be. 

Terrible as are the ills that follow in the wake of this vice, it is 
possible for an opium eater to be cured. The book named already 
is proof unanswerable. The author of the Confessions was moved 
to write his little volume chiefly by the happy reflections sug- 
gested by his own rescue. He felt his miserable condition deeply, 
and, ere it was too late, sought and obtained relief. He was ad- 
vised to take the ammoniated tincture of valerian as a substitute 
for his opiate stimulant ; he obeyed the instructions of his physi- 
cian, and was saved. 

The principle involved in this mode of curing the vice of opium 
eating is very simple. It is the same that runs through the 
whole practice of physic — the substitution of one stimulus for 
another. The medicine prescribed for the author of the Confes- 
sions was a combination of stimulants, and all of them capable 
of exerting a considerable influence on the nervous system. 
Chardin tells a story that forcibly illustrates the same principle. 

41 



634 CUMULATIVE POWER OF OPIUM. 

Some Turks were taken prisoners, and were at sea so long that 
their stock of opium was exhausted. As a consequence of the 
lack of a long-familiar stimulus, made by the force of habit 
almost essential to life, they sickened and became very ill, were 
wretched and despairing. The captain of the ship having no 
opium on board, at length fancied that his wine might possibly 
be of some service to the poor sufferers. He tried it, and the 
experiment was successful. 

So long as the Turks were able to repeat the opiate potion 
they realized more or less of its stimulation. Its total absti- 
nence made indirect debility unavoidable. Body and mind felt 
the shock together ; deep depression and anguish followed, and 
would have augmented to a fatal issue if some other stimulant 
had not met the emergency. Wine accomplished the purpose, and 
alcohol would have done the same in any form, and so would 
stimulants and tonics of various grade. The tincture or the milk 
of assafoetida would be very useful in such a case, just as they 
have often served to protect a reformed drunkard from serious 
injury who had suddenly abandoned his cups. 

The duty of physicians in reference to opium eaters is very 
plain. If their sensibility be not wholly gone, warn them faith- 
fully of the danger of their position, urge them to break away 
at once and forever, at all hazards, from the deadly habit and 
all its associate evils. Persuade them to try the compound infu- 
sion of calumbo or gentian, the milk or the tincture of assafoetida, 
very frequently in the day, and every day ; let the bowels be 
kept in a regular state, the food be simple, easily digested, yet 
sufficiently nutritive, and urge them to eat a little whether they 
relish it or no. It may be needful to exhort and urge them over 
and over again ; but if a moderate share of resolution can be in- 
spired and continued, they will be saved. In some cases it may 
be proper, before the use of tonics and stimulants is attempted, 
to administer an emetic or two of mustard or chamomile, in order 
to rouse the latent energies of the stomach and to improve its 
mucous membrane. 

Opium, under more favorable circumstances, is often a source 
of mischief. Even when administered by physicians, it has 
occasionally done harm and no good. Thus, a man is suffering 
severely from colic. The pain must be relieved at all risks, and 
dose after dose is administered. So long as the remedy was the 
antagonist of the pain it did no injury ; but more has been taken 
by the patient than the pain called for. The cumulative quality 
of the poison is soon developed, and the man dies of coma. Such 
a case is reported in the Edinburgh Medical and Surgical Jour- 
nal for October, 1834. 

The usual effects of an overdose of opium are headache, ver- 



EFFECTS OF AN OVERDOSE. 635 

tigo, delirium, stertorous respiration, stupor, pale and cadaverous 
countenance or a countenance deeply suffused, fixed pupils, re- 
laxed muscles, the lower jaw fallen, skin cold, &c. &c. In respect 
of the quantity that can induce all these results, and finally kill, 
there is no rule, and there can be none. A woman desired to 
get rid of a useless husband laboring under a disease regarded 
as incurable. She managed to make him swallow twenty grains 
of opium at one dose, and yet was most grievously disappointed. 
A tremendous perspiration came on, followed by a very profuse 
urinary evacuation, and he was cured. Others have taken im- 
mensely large portions of opiate medicines at times when under 
the highest pressure of mental excitement, and were not de- 
stroyed. A medical student in Germany took twenty-five 
grains of acetate of morphia, and was not seen till ten hours 
had elapsed, and yet he recovered by active treatment. His 
mind was in a terribly excited condition, but little removed from 
actual insanity, and this proved a counterpoise to the dose which, 
under other circumstances, would probably have destroyed him. 
But the Annates de Hygiene for January, 1845, furnish a more 
remarkable case. An apothecary's assistant, aged twenty-four, 
swallowed at noon fifty-five grains of acetate of morphia in two 
ounces of gum-water. He then sent a letter to his master in- 
forming him what he had done. The master came in half an 
hour, and administered with difficulty, and without effect, two 
grains of tartar emetic in an ounce of water, followed by an 
ounce or two of sweet oil. Up to this time the chief symptom 
was slight giddiness, which soon vanished, and the man went out 
with some companions and drank half a bottle of beer. At the 
end of an hour and a half he complained of more giddiness, a 
peculiar feeling in the limbs, and a tendency to sleep. At the 
end of two hours he was taken to the hospital, put to bed, and 
made to take three grains of tartar emetic and twenty-four of 
ipecacuanha, in two doses, with an interval of half an hour. 
Vomiting could not be effected without the aid of an irritant to 
tickle the throat, and then it was too slight to do good. The 
aspect of the case grew more and more alarming, till at length 
he fell into a profound sleep, and seemed like a drunken man. 
During all this the breathing continued quite natural. A pound 
of blood was taken from the arm, soon after which the patient 
rallied a little, and complained of difficulty in swallowing. The 
pulse, which up to this time was soft and frequent, became full, 
hard, and slow, and there was troublesome itching of the fore- 
head, nose, and lips. Various external irritants and agitation 
of the whole body were resorted to in vain. The face was dis- 
torted, the eyes dull and sunken, the entire surface of the body 
of an icy coldness. At the end of three hours, iodine and hy- 



636 POISON OF OPIATES. 

driodate of potash were administered, and vomiting ensued. 
Strong coffee frequently given had a like effect. At the end of 
five hours, a third bleeding was performed, strong coffee pretty 
freely taken, and two blisters applied to the chest. From this 
time he began to improve, and conversed a little. At the end of 
six hours, he inquired whether he was not very ill, and wondered 
that he had survived the monstrous dose of fifty-five grains of 
acetate of morphia. In two or three days he was well. 

In the above case there is no evidence of any high mental 
excitement to counteract the poisonous dose, and it is altogether 
strange that recovery did ensue, especially as the poison was 
not early dislodged by vomiting nor neutralized by an antidote. 
It presents the largest opiate dose ever taken with comparative 
impunity. Allowing only four grains of opium as the equivalent 
of a grain of the acetate of morphia, the man took more than two 
hundred grains of opium. 

Very much depends on the actual state of the body and mind, 
as to the result in cases of over-dosing, although we may not be 
able to see and appreciate that state, for this we cannot always 
do. Something may be due, also, to the quality of the anodyne 
or narcotic preparations as to relative strength, and this may 
not always be known. A few drops will kill a child that may 
have taken a larger dose on some previous occasion, or one that 
never took the medicine before. Laudanum or paregoric may be 
poured from a bottle containing a good deal of sediment, which 
may also be poured out and so augment the strength of the dose. 
A child five and a half years old was thus killed by a very small 
portion of paregoric elixir, probably not half a teaspoonful. (See. 
Edinburgh Medical and Surgical Journal, 1844.) I attended 
a child to whom four drops of laudanum were administered, as 
had been done before with no obvious injury, and with great diffi- 
culty was the poisonous action controlled by the frequent exhibi- 
tion of emetics. We infer not only that the altered quality of 
the usual dose may be influential, but that a good deal depends 
on the actual sensibility of the stomach at the time when the 
hurtful dose was swallowed. The fullness or emptiness of the 
stomach is also a matter of great importance in this relation. 
An ounce or two of laudanum, taken by a man immediately 
after a full ; dinner, might do very little mischief, and yet the 
same man might be killed in a week afterward by half an ounce 
taken on an empty stomach. 

It is asserted in the Edinburgh Medical and Surgical Jour- 
nal, 1846, that three grains of the acetate of morphia mixed 
with bran and water did not in the least degree affect a rabbit ; 
and yet three children were so badly poisoned by sucking unripe 
poppy-heads that two of them died. (See Banking, vol. i. p. 322.) 



TESTS AND ANTIDOTES. 637 

There are various modes of ascertaining whether a patient is 
under the influence of this drug, apart from the usual symptoms 
before adverted to. If you inspect the breath carefully, you may 
detect the peculiar opiate smell; and if a post-mortem examina- 
tion be made, the same smell may be further manifest.- The 
common chemical expedient depends on the reaction of a persalt 
of iron upon the meconic acid in opium, a deep-red color being 
struck. Having filtered the contents of the stomach, add to the 
clear liquid some solution of the sugar of lead. This will give 
rise to meconate of lead, if opium be in the solution. Separate 
this precipitate and decompose it by the addition of a few drops 
of sulphuric acid passed down a glass tube to the precipitate, 
which is covered with water. The meconic acid is instantly set 
free, and by passing down the tube a very little of a solution of 
persalt of iron, you strike the red color instantly. This test is 
not applicable to the usual salts of morphia, because they con- 
tain no meconic acid. 

There are probably few articles possessed of true antidotal 
power on chemical principles in respect of opium. It has been 
said that iodine and chlorine will decompose all vegetable pro- 
ducts that contain hydrogen, and thus destroy their essential 
nature, but this wants confirmation. Orfila proposed the solu- 
tion of potash and soda to neutralize the salts of morphia, by 
throwing the alkaloid down as an insoluble precipitate. Tannin 
is more truly an antidote than any other agent ; and though best 
administered in its pure form, can be well given in the shape of 
very strong coffee. This fact explains the successful action of 
strong coffee long before tannin was discovered or much talked 
of. Facts in abundance could be adduced in this respect. 

The stomach-pump, emetics of the prompt kind, as sulphate of 
copper and sulphate of zinc, flagellation, dashes of cold water on 
the naked body, rubefacients, the actual cautery, galvanism; all 
these have proved effectual, and all have failed. 

In Turkey, if a person happen to fall asleep in or near to a 
poppy field, so that the fumes exhaled shall come in contact with 
his body, he becomes gradually narcotized, and would die if the 
country people, who are well acquainted with these matters, did 
not carry him to the nearest stream and duck him in it, or pour 
pitcher after pitcher of water on his naked body. — Graves's 
Clinical Lectures, p. 37. This well-established fact proves con- 
clusively the efficacy of the cold dash in this and other cases of 
narcotic poisoning. 

Not unfrequently patients can be saved by early and copious 
vomiting, followed by free draughts of diluted lemon-juice or 
vinegar, to restore the lost tone of the stomach. In regard to 
the stomach-pump, it is well to give a caution, in order to pre- 



638 TREATMENT OF OPIATE POISONING. 

vent its disuse because one effort fails. Mr. Wakely, in a paper 
published in bis London Lancet, declares that after several 
failures, be has at last succeeded with it in extracting a ropy 
fluid containing considerable portions of the opiate poison. 

It is also well to know that deep narcotism may remain after 
the freest evacuation of the stomach, and that too at an early 
period. A girl, aged nineteen, took an ounce and a half of 
laudanum. In a little more than an hour she was put under 
treatment. Full doses of the sulphate of zinc were given, and 
the stomach-pump was also employed. The stomach was doubt- 
less emptied, and yet the narcotic effects of the poison not only 
remained, but actually increased in intensity. She was saved, 
however, by being kept in constant motion by two waiters, 
pinched severely, and put under the irritation of mustard plas- 
ters. Another case is reported in the Edinburgh Medical and 
Surgical Journal for 1838, as follows: — A young man, aged 
twenty-five, took a large quantity of laudanum and soon became 
insensible. The stomach-pump and other expedients were of no 
avail, and the case became nearly hopeless. At length it was 
agreed to make the experiment of ai*tijicial respiration, as the 
action of the lungs had nearly ceased. A common pair of bel- 
lows served the purpose of inflation, the mouth being closed to 
augment the effect. This device was perseveringly employed for 
more than an hour, aided by turpentine injections. The man 
recovered. 

Several cases are reported in which, after failure by the usual 
means, the action of a small galvanic battery addressed to the 
spine and epigastrium proved effectual. M. Erichsen, in the. 
Edinburgh Medical and Surgical Journal for January, 1845, 
reports the case of an infant poisoned by a few grains of Dover's 
powder, and saved by the action of an electrical machine, after 
cold dash, counter-irritants, &c. had failed. He directs the shocks 
alternately to the epigastrium and spine. 

In Christison On Poisons, and kindred works, cases of com- 
pound poisoning, as they are called, may be found, which pos- 
sess considerable interest. Thus, thirty grains of opium mixed 
with sixteen of sugar of lead were swallowed by a seaman in 
mistake. He had an ulcerated leg, for which the preparation 
was intended. At 8 p.m. the dose was swallowed, and at mid- 
night the man felt a little unwell and vomited. He rested badly, 
yet without a sign of narcotism, and on the next day felt about 
as well as usual. — Edinburgh Medical and Surgical Journal, 
1841. In the same journal is another case. A patient took 
sixty grains of opium with twenty of sugar of lead in mistake. 
In half an hour the error was discovered, and an emetic was ad- 
ministered. No serious consequence followed. 



OXYGEN GAS. 639 

When we call to mind the almost universal employment of 
opiates in families as a merely domestic medicine, the frequency 
of its exhibition by medical men and quacks, the facility with 
which it can be procured, even by servants black or white, as a 
means of self-destruction, we wonder, not that it kills so many 
individuals, but that it is not the occasion of a thousand more 
fatal results than have ever been attributed to it. What could 
the world employ as a substitute? How could mankind tolerate 
its annihilation. 

To guard against accidents, every preparation of opium should 
be so distinctly labeled that no one could be mistaken for an- 
other; and to this end the plainest English terms are decidedly 
better than the purest technicalities in Latin. Everybody can 
understand the words opium, paregoric, laudanum, &c. more 
certainly than any other terms that medical men recognize as 
synonyms. This may seem to many an unimportant kind of 
advice, but in my judgment it is of sufficient value to commend 
itself to the serious attention of every true philanthropist; and 
for this reason I am solicitous that it may have a salutary in- 
fluence on the professional mind, and thence make its impress 
on the community. 

Oxygen Gas. — In these days of inhalation-notoriety and 
marvel, it cannot be out of place to introduce to the notice of 
our readers a remedy that once had high repute as a part of 
the pneumatic medicine of Beddoes and his cotemporaries. 
Oxygen gas is as essential to life now as at any former period, 
and will be so to the end of time; and this fact creates a basis 
for the conjecture, at least, that its judicious employment as a 
remedial agent may be salutary. It is not easy to perceive how 
even the infinitesimal practitioners could object to its adminis- 
tration in small doses, when they and all their patients are com- 
pelled to take it in very large portions or die. They make a 
show, at least, of imitating Nature so far, that to oppose her 
established law in this respect would savor not a little of incon- 
sistency ; a feature, it is true, so fashionable among professional 
men as scarcely to excite remark. 

The grand, prominent, therapeutic quality of this gas is sti- 
mulant, and though absolutely essential to animal life, may de- 
stroy it, and hence it is sometimes called a narcotic or poison. 

Various articles can be made to yield this gas copiously; but 
the purest is obtained by exposure of the chlorate of potash to 
an elevated temperature. In fact, absolutely pure gas cannot 
be procured easily from any other source. A common elastic 
or oiled silk bladder, furnished with an ivory mouthpiece, is all 
that is necessary for the inhalation of this gas, which may be 



640 USES OF OXYGEN GAS. 

employed pure or mixed with variable quantities of atmospheric 
air, as the occasion may suggest. 

In one of the early volumes of Sillimans Journal there are 
recorded some interesting cases of pulmonary consumption cured 
by the persevering inhalation of this gas. With all due allow- 
ance for possible error in diagnosis, and the probable absence of 
real tubercular phthisis in the cases reported, there can be no 
doubt that the remedy employed very materially relieved the 
condition of the lungs, whatever may have been their patholo- 
gical state; and viewed in this light merely, the inhalation is 
entitled to favorable notice. In Chaptal's Chemistry, edited by 
the late Professor Woodhouse, the reader may find cases of a 
like character treated in the same way. But the most copious 
notices of the remedial value of oxygen gas are to be seen in 
Dr. Hill's volume on the medical uses of oxygen, published in 
England in 1800. Asphyxia, dyspnoea, and other difficulties in 
the respiratory organs are named as successfully treated by this 
agent. Some of the foreign journals inform us that the inha- 
lation of oxygen gas and its injection into the veins were tried 
in cases of Asiatic cholera, and sometimes with marked success. 
It has very recently been announced in the India News that 
Dr. Macrae has employed this gas very successfully in the hos- 
pital at Howrah. Fifteen patients in the last stage of cholera 
were treated by this article, and all recovered. The inhalation 
induces a long and refreshing sleep, from which the patient 
awakes in an enfeebled state. 

There can be no doubt (for, in fact, the doctrine has been 
avowedly made the basis of the practice) that the idea has exten- 
sively prevailed that in many diseases a deficiency in the oxygen 
of the system, and especially of the blood, was the secret yet 
efficient source of the existing evil. The gas was therefore re- 
sorted to as a certain expedient, to compensate for a defect either 
imaginary or real. The grand difficulty lies in the certainty or 
uncertainty of the premises, and the power of control necessary 
to guard the remedy from inflicting a worse evil than it was 
designed to remove. 

We are told in McKenzie's One Thousand Experiments that a 
lecturer on chemistry was nearly asphyxiated by the accidental 
inhalation of carbonic oxide gas, and very speedily relieved by 
the use of oxygen gas. We know also that persons almost de- 
stroyed by breathing an air made foul by the fumes of burning 
charcoal have been resuscitated by the same expedient. 

As this gas is confessedly a stimulant in its primary action, 
it should invariably be administered on the same principles that 
regulate the use of other stimulants. That it may have done 
good, as is stated, in low typhus and other diseases of prostra- 



PALLIATIVE TREATMENT — PANACEA. 641 

tion, we can readily understand and believe, while, on the other 
hand, we could expect only unfavorable results after its exhibi- 
tion to a highly excited system. 

Tilloch's Philosophical Magazine contains a number of inte- 
resting statements touching the remedial powers of oxygen gas, 
that may be consulted with profit. 

Palliative Treatment. — There are patients who cannot be 
cured. Laboring under organic disease or malformations which 
make it certain they must die, or being in the advanced periods 
of disease that we know will destroy life, our professional aid 
can avail nothing in respect of cure. We see the end, but can- 
not stop the march of the malady. But we may palliate, miti- 
gate, render comparatively comfortable, and this is often very 
desirable. To soften the last agonies, to smooth the passage 
out of life, by the administration of the most agreeable prescrip- 
tions, is a duty that devolves on every practitioner, the faithful 
discharge of which will often secure for him the most abiding 
friendship and confidence. It is not needful to enlarge on this 
point, as every case must indicate its appropriate management 
in this respect. A judicious physician will not be slow to devise 
fit expedients for each emergency. 

Panacea. — This term means literally a cure-all; and so the 
people, and especially the whole race of quacks would seem to re- 
gard it. To such an extravagant length has the mania on this sub- 
ject extended, that our newspaper literature may be pronounced 
truly to be a panacea-literature, to a very large extent. This un- 
blushing impudence stains more than two-thirds of the newspapers 
of the country, and the evil is on the increase. We suppose the 
solution is not difficult, but can be found readily in the semi- 
omnipotence of cash, which has the wonderful facility of speak- 
ing all languages while it is the conservator of human motives 
to an almost unlimited extent. The common sense of a man of 
ordinary intellect revolts from the idiotic nonsense of a panacea, 
because he knows and feels that such a thing never existed and 
never can. A moment's reflection will satisfy any one that 
human diseases are even more dissimilar than human faces, for 
the plain reason that no two constitutions are precisely alike. 
Every well-instructed physician knows that during the preva- 
lence of a powerful epidemic that controls and modifies all other 
diseases for the time being, there are no two patients in whom 
all the features of the epidemic are alike; and the same great 
principle runs through the entire range of morbid action. How 
absurd, then, is the effort to practice on the community the pal- 
pable fraud of a panacea that is to cure everybody, even of the 
same disease! And how ineffably ridiculous is the course so 
often adopted by clergymen in certifying the success of a cure- 



642 PAREIRA BRAVA. 

all in any disease, and more especially in one of whose nature 
and existence they know no more than does an infant nine days 
old of the physical geography and population of the moon ! 

We fear that the conduct of many who profess to have more 
than ordinary intelligence touching this matter may be traced 
to recklessness and want of system on the part of medical men. 
Did physicians eschew all specifics and habitually adapt their 
remedies to the circumstances of each case, they could not fail 
to exert a good influence on the common sense of mankind. 
Such a course, practically enforced, would lead to a more correct 
public sentiment in reference to the action of medicines; and 
then it would only require the influence of a little more honesty 
to exclude the very idea of panaceas from all intelligent society. 

As apt illustrations of the doctrine herein reprehended, we 
name pulmonary consumption and cancers. The papers are 
flooded with certificates of clerical and other quacks, touching 
the omnipotence of this and the other trashy compound to cure 
the diseases just named. These mountebanks assume that they 
are judges in the premises, when, in fact, they have no better 
diagnostic acquaintance with either pulmonary consumption or 
cancer than the most hopeless lunatic in our insane hospitals. 
They delude hundreds and thousands, by the influence of their 
position in society, touching a matter about which they are most 
profoundly ignorant, to the manifest detriment of the regular 
medical profession, whose gratuitous services they look for as a 
matter of right when too sick to be relieved even by their own 
miraculous panaceas. The time has fully come when such men 
should be made to feel the folly of their own ingratitude, in the 
refusal of medical men to serve them day and night, without the 
reward even of thankfulness for such unmerited philanthropy. 

Pareira Brava. Cissampelos Pareira. Native of the West 
Indies and South America. — The plant is known in Jamaica 
under the name of the walnut leaf and ice vine. It grows 
abundantly in the mountain districts, attaining to great size, 
and covering the tallest trees with its velvet foliage. It was 
first noticed particularly by Margrave and Piso, who spoke of 
the root as used by the natives of Brazil for bowel and urinary 
diseases. The root is about as thick, ordinarily, as a finger, 
but sometimes is seen as stout as an arm, from two to four feet 
long, cylindrical, contorted, forked, and coated with a thin, 
smooth, brown bark. Within, it is ligneous, yellow, porous, in- 
odorous, nauseous, and having a taste blending the bitter and 
sweet. The Portuguese employed it in the year 1680 for dis- 
eases of the bladder and kidneys. It fell into disuse, and was 
for a long time scarcely talked of. Subsequently it was revived, 
and acquired popularity as a remedy for the same affections to 



PAULLINIA. 643 

which it had been previously applied. Some have called it a 
liihontriptic, because of its action on the urinary organs and 
calculous deposits. It has been tried, with various success, in 
dropsy, leucorrhoea, jaundice, and rheumatism. 

Dr. Betton, late of Germantown, in Pennsylvania, has reported 
some interesting facts touching its exhibition in cases of irri- 
table bladder. (See American Journal of Medical Sciences, vol. 
xvii.) Mr. Thompson, surgeon of Westminster Hospital, gave 
similar facts in one of the foreign journals in 1839. He com- 
bined eight ounces of the pareira decoction with two drachms of 
phosphoric acid, and gave his patients an ounce twice a day. 
In addition to the power of the medicine to allay irritability of 
the bladder, Mr. T. regards it as a good, tonic. He combined 
it sometimes with opium or extract of henbane, if the patient 
suffered severe pain. 

In Brazil this article has long been employed to avert the evils 
likely to flow from the wounds of poisonous serpents. The bruised 
leaves of the plant are kept constantly on the bitten part, and a 
vinous infusion of the root is administered internally. The dose 
of the powdered root is from thirty to sixty grains for adults. 
The dose of the infusion, made by digesting a half-ounce of the 
leaves or root in a pint of hot water, is two fluidounces three 
times a- day. The decoction is not made quite so strong, because 
the process of boiling augments the power of the medicine. A 
watery extract has also been employed, in doses of from ten to 
twenty grains. 

The article is not much known to the profession at large, 
though it can be had in many of the principal drug stores. 

Paulllnta. Paullinia Sorbilis. — This is comparatively a new 
article, and is identical with what has been called guar ana. It 
is a native product of Brazil, and was first obtained by the 
Indians. The word guarana is from the semi-savage people who 
extract it from the plant, and have long valued it both as diet 
and medicine. 

In order to prepare the article, the clean seeds of the plant 
are bruised in a mortar, then roasted on an earthen plate, and 
the powder so furnished is moistened with water and set aside for 
the night. The soft mass is next made into cakes weighing one 
pound or a little more, and these are well dried in the sun or by 
means of a fire. The latter process gives them a black aspect, 
and hardens them. The cakes are called the extract ; and it is 
really an extract, and may be kept for years, if well surrounded 
with leaves and otherwise guarded against moisture. The 
specific gravity of this substance is 1.3. It swells and becomes 
softer by the action of water on it. Its taste is somewhat rough, 
not unlike rhatany, although nearly void of bitterness. 



644 PELLITORY OF SPAIN — PEPSINE. 

The Indians carry these cakes with them when about to under- 
take a journey. When they wish to partake of them, a fish-bone 
is rubbed smartly on the cake to reduce it to powder, and the ad- 
dition of sugar and water converts the mass into an antifebrile 
and refreshing drink. They add the powdered cakes also to 
chocolate, in order to increase its tonic and nutritive qualities, 
without materially affecting its taste. The roots of the plant 
are employed by the Indians in decoction and infusion for the 
cure of fevers. 

Although the extract is very slightly astringent, Gomez tells 
us it is efficacious in dysentery and urinary diseases attended 
with relaxation, and is so employed in Brazil. The dose is from 
twenty to seventy-five grains in a wineglass of water. 

While guarana is used identically with paullinia, that name is 
given to a vegetable alkaloid obtained from the extract by several 
chemists. Garelle, who frequently employed both the extract 
and alkaloid in the Brazils, sent some of both to France, where 
it proved equally medicinal. These preparations were exhibited 
in chlorosis, palsy, the diarrhoea of phthisis pulmonalis, head- 
ache, tardy convalescence, &c. &c. 

The tonic powder of the paullinia depends chiefly on the tan- 
nate of caffeine, which abounds in it. It is said that alcohol 
readily takes up the active properties of this plant, and there- 
fore we can make a tincture as well as an alcoholic, or, rather, a 
hydro-alcoholic extract. A syrup is readily made also from the 
extract, and is a good mode of exhibition. It has also been em- 
ployed in the shape of ointment. 

So far as I can learn, this medicine has not been much em- 
ployed in this country ; but it is quite possible it may prove to 
be a valuable auxiliary. 

Pellitory of Spain. Anthemis Pyrethrum. — This root, well 
known to the ancients, is a native of Africa, whence it was intro- 
duced to Europe. It has no odor, but an acrid, pungent taste, 
causing a flow of saliva. The active principle is soluble in alco- 
hol and ether, and is a volatile oil. The properties are those of 
an irritant and sialagogue ; and it has been employed chiefly in 
toothache and palsy in consequence of those qualities. Very 
seldom in use now. 

Pepsin, or pepsine. — This is from the Greek word meaning 
to digest, and denotes a substance found in the gastric juice, 
and on which its energy depends. It is a modification of albu- 
men, and seems to act like a ferment. 

As this article has attracted the notice of the profession every- 
where as a remedical agent, especially in cases of impaired diges- 
tion, and as spurious samples are now sold, it is deemed advisa- 



GENUINE AND SPURIOUS PEPSINE. 645 

ble to give the following brief note on true and false pepsine, as 
furnished by Mr. Squire in the Lond. Lancet for July, 1857. 

"I propose to point out the characters by which the genuine 
article may be recognized, and likewise those presented by the 
counterfeit ; and also to describe the chemical tests by which they 
may be distinguished from each other. 

" I have taken as the normal type the preparation originally 
introduced by Mons. Boudault, the manufacturer in Paris, 
as described by him in a paper read before the Academy 
of Medicine. The process employed consists in digesting the 
mucous membrane of the rennet-bag in distilled water, precipi- 
tating the pepsine by acetate of lead, and decomposing this 
precipitate by sulphureted hydrogen. A solution of pepsine, 
nearly pure, is thus obtained, which is evaporated at a gentle 
temperature to a syrup ; it is then mixed with starch in such 
proportion that fifteen grains of the resulting mixture shall 
possess the power of digesting one drachm of dry fibrin. The 
preparation generally used contains, in addition, a small propor- 
tion of lactic acid. The article sent into the market by Mons. 
Boudault presents the appearance of a light fawn-colored, some- 
what cohering powder, possessing a peculiar odor and taste. 
When treated with cold distilled water and filtered, an amber- 
colored fluid passes through, while the starch remains behind. 
The spurious article, however, is a coarse white powder, without 
either taste or smell, and, when treated with cold distilled water, 
partially gelatinizes, filters with great difficulty, and yields a so- 
lution perfectly colorless. The insoluble matter which remains 
behind, when examined by the microscope, consists apparently of 
a mixture of starch and animal membrane, which may be readily 
separated by washing with water, the starch remaining in suspen- 
sion, the membrane caking together and sinking to the bottom. 

" Let us now examine these solutions with different re-agents. I 
shall, by way of distinction, call Mons. Boudault's preparation 
true pepsine, the other false : — 

True Pepsine. Test. False Pepsine. 

Abundant precipitate . . ) » '. e , -, ar ",. -, •,. 
(Peptate of lead) Ditto. } Acetate of lead . Slight cloudiness. 

(Tannate of pepsine) . . . Tannin Ditto. 

Precipitates of pepsine . . Alcohol No effect. 

" The solution of true pepsine is strongly acid to litmus, while 
the false is so only in a slight degree ; but, more than all, Mons. 
Boudault's preparation does what it professes to do : fifteen 
grains digest its drachm of dried fibrin, while the spurious com- 
pound is entirely destitute of this property." 

This article has the power of speedily dissolving animal 



646 PERCUSSION — PHLORIDZINE. 

matters out of the body and reducing them to a soft pulp. 
Hence its use as a remedy to augment the natural power of the 
stomach to digest food. It is kept on sale in the drug stores, 
and can be used in pill, in doses of three grains to twenty, several 
times a day. It is perfectly safe. 

We refer the reader to part xxxv. of Braithwaite, p. 298, for 
details of the successful use of pepsine in various forms of dys- 
pepsia, &c. &c. 

Percussion. — This is a comparatively modern aid to the phy- 
sician in the investigation of disease, and is most frequently ap- 
plied to the chest. It is effected by striking with the ends of 
two or three fingers, or a small round stick, over various portions 
of the chest. The philosophy of the sounds thus heard is pre- 
cisely of the same nature as when we strike on an empty barrel, 
and then on a barrel full of liquid. In the former we get a 
clear, and in the latter a dull sound. We learn by this aid 
whether the chest contains effusion of any kind, or whether there 
is no impediment of this sort to the detection of the natural 
sounds of healthful respiration. 

Phloridzine. Phloos and ridza — root of apple-tree. — The 
original source is thus indicated, although it has been prepared 
from the root bark of other fruit-trees. The French, German, 
find Polish physicians have spoken highly of this new medicine 
as a substitute for the different forms of cinchona. It is extracted 
from the bark of the roots of the apple, plum, and wild-cherry 
trees, and may be obtained thus : — The bark of the recent roots 
is boiled, with water sufficient to cover them, for half an hour. 
The fluid is poured off, and as much more poured in for a second 
boiling. This, with the other portion of liquid, being placed in 
a clean vessel and set aside to remain undisturbed for at least 
six hours, will furnish the new article. The phloridzine falls 
pretty copiously, in the form of a deep-red velvety-looking mat- 
ter. To make it as nearly white as possible, the mass is to be 
boiled with animal charcoal in a sufficient quantity of pure water, 
and afterward to be well washed and dried. It is slightly 
bitter, but not astringent ; dissolves in alcohol, but is nearly in- 
soluble in water. 

Boullier, who first prepared it, sent parcels to several distant 
physicians for trial, and all reported favorably. M. Lebandy, 
editor of the Journal des Oonnaissances Medico- Chirurgicales, 
says, " Its efficacy is so decided that we cannot hesitate to class 
it with the most powerful febrifuges ; and it has this advantage 
over sulphate of quinine, that it never induces gastralgia. The 
adult dose is from ten to twenty grains, given in pill or powder." 

Phloridzine may be distinguished from salicine by its not yield- 
ing a red solution with sulphuric acid. When moistened with 



PHOSPHORUS. 647 

ammonia and exposed to the air it absorbs oxygen and becomes 
blue, and if then dissolved in ammonia the solution yields a red 
powder on the addition of acids. 

Phosphorus. — This article was formerly much employed in 
practice, but is at present seldom exhibited. It is obtained from 
phosphoric acid by the decomposing energy of charcoal. The 
question is often asked, Whence comes the large quantity of 
phosphorus found in the human structure, in the urine and bones? 
This has been answered, in part, by a writer in the Medico- 
Chirurgical Transactions, vol. x. He says that phosphoric 
acid exists largely in many vegetable and animal matters that 
enter into our daily food. Mr. Barry, in experimenting on phar- 
maceutical extracts, in vacuo, found this acid present in all the 
extracts in a soluble state ; he found it also in most esculent 
vegetables. 

The color of fresh and pure phosphorus is nearly white, with 
a faint tinge of yellow. When exposed to the light a good while 
it assumes a darker color. Its rapid combustibility, even by the 
slightest friction, renders it necessary to preserve it in water. 
Though insoluble in water, it dissolves in alcohol, ether, and oils. 

The ethereal solution has been more commonly employed than 
any other preparation. It is made by adding to an ounce of 
sulphuric ether a drachm of phosphorus, cut into very small bits. 
The bottle must be kept well closed. The dose varies from ten 
to forty drops, and is best administered on sugar. As the stimu- 
lant effect, though real, is liable to pass off soon, the dose should 
be often repeated. 

The solid phosphorus has not often been administered, and 
rarely in doses larger than an eighth of a grain, which may be 
gradually augmented. It is best given in the form of pill, being 
easily enveloped by conserve of roses, or mucilage, or soft ex- 
tract. A single grain, taken at a dose, destroyed life. A 
French chemist determined to test the power of phosphorus in 
his own person, and took a grain, with a good deal of sugar, for 
his first dose. On the next day he tried two grains, and on the 
next, three. Violent vomiting soon came on, with inflammation 
of the bowels, delirium, spasms, &c, and although vigorous 
measures were adopted, he perished, a victim of his own folly. 
The London Lancet for 1843 reports a fatal use of phosphorus, 
as a medicine, in much smaller doses. And in the American 
Journal of Medical Sciences for October, 1843, may be seen an 
article showing the poisonous action of lucifer matches, made, in 
part, of this substance. Those who have examined, however 
slightly, the article sold in tin boxes to kill roaches and rats, must 
have detected the presence of phosphorus in the mixture. It is 
added to render the exterminator more certainly poisonous. 



648 PH0SPH0KUS A POISON. 

Several cases are furnished by Mr. Taylor, surgeon in Not- 
tingham, (England,) showing the pernicious effects of phosphorus 
on the workmen in manufactories of lucifer matches. Necrosis 
of the maxillary bones, followed by exfoliation, is attributed to 
this agency. This effect has been ascribed to the constant respi- 
ration of phosphoric vapors, which became acidified, r and acted 
chemically on the bony structure. The operation appears to 
have been very gradual. (See London Lancet, March, 1850.) 

The same injurious action is noticed by Mr. Simon, in a lecture 
on clinical surgery. He says the constitution suffered serious 
deterioration, calling for tonics and occasional anodynes in addi- 
tion to the proper local treatment. 

The pervasive influence of phosphorus was noticed very early 
in the history of its medical administration. On making a full 
dissection of a dead body after either the directly poisonous 
or remedial use of the article, the entire lining of the abdomen 
has been found quite luminous, and other parts in like con- 
dition. 

When large portions have been swallowed with intent to kill, 
or by accident, we find the usual symptoms of poisoning by the 
mineral acids, and thesame general treatment is proper. A con- 
troversy was started some years ago in this city, to decide 
whether the fatal action of phosphorus, taken into the human 
stomach, depended on its power to corrode that organ, or on the 
irritant quality of the phosphoric acid generated there. The 
obvious impracticability of determining such a point was so ap- 
parent that the disputants became ashamed of it, and the matter 
ended. 

The external poisoning by phosphorus is very severe, tedious, 
and difficult to manage. There is not only a burn inflicted, but 
a burn of special character. It is a phosphorus-burn and & phos- 
phorus-ulcer that create the difficulties in the matter of healing. 
Having had quite enough personal acquaintance with this feeling 
in reality, I can with truth declare that no pain is so peculiarly 
distressing as that inflicted by the combustion of phosphorus on 
the skin. The ulcers are exceedingly slow to heal ; at least such 
was the nature of this thing in my own person. 

As the most certain expedient for obtaining a little relief from 
the burning sensation immediately after an accident of this sort, 
I feel confident that nothing can compare with ice-cold water, 
renewed and continued for hours. The lime liniment, spoken of 
under the article Calx, is one of the best applications that can 
be made to the ulcers left after the inflammatory action has 
nearly subsided. 

The earliest notice of the remedial use of phosphorus is in 
Haller's Collection of Theses. Cases are there detailed showing 



USES OF PHOSPHOKUS. 649 

the successful use of the medicine in chronic diarrhoea, the last, 
or typhoid stage of bilious fever, malignant catarrhal fever, &c. 

In the English Quarterly Journal, vol. xiii., Dr. Miller re- 
ports success in the treatment of jaundice with phosphoric acid 
in balm tea ; but he omits to name the dose. The previous treat- 
ment consisted of a cathartic of calomel and jalap, which was 
repeated if necessary. The phosphoric mixture was given till 
free diuresis came on, and the urine made perfectly clear. In 
three or four days the yellow tinge of the skin entirely dis- 
appeared. 

Phosphorus has been employed successfully by an English 
physician, in the advanced stage of cholera, usually regarded as 
hopeless. In 1833 he published his experience with this medi- 
cine in the London Lancet, and in the same journal for Febru- 
ary, 1850, he reiterates the same views. His reliance has been 
chiefly on the following prescription : — 

R. — Phosphor, ^ss; 
Cer. alb. gss. 
With the aid of enough water to avoid combustion, rub these articles well 
together, divide the mass into ten pills, which should be kept in a small bottle 
containing pure water. 

In far-advanced cases, these pills were the only reliable medi- 
cine. One was given every ten minutes, followed by a little 
water. Three pills usually sufficed to arrest the cramps, the 
vomiting and purging. In milder cases, the first medicine given 
was as follows : — 

R. — Nit. acid fort., from three to fire drops; 
Tinct. opii, four to eight drops; 
Syrup croci, a drachm; 
Aquae, an ounce and a half. 
Mix for a draught, which very frequently answered the end in view. If this 
failed, the pills were administered as above stated. 

Some six or eight cases are detailed to show the value of this 
practice. (See London Lancet, February, 1850.) 

A considerable number of cases reported by Dr. Wolff, in 
1T93, would seem to show the good effects of phosphoric ether 
in low fevers attended with delirium, tremors, feeble pulse, pe- 
tecchise, &c. Five drops of a very strong solution were given 
every three hours. The pulse improved after a few doses had 
been given, and equable heat pervaded the system, a pleasant 
moisture covered the skin, and the delirium subsided. Much 
testimony of a similar nature could be adduced; and there can 
be no doubt that salutary results have followed in judicious 
hands. It is true, however, that much mischief was apparent, 
as the consequence of the indiscriminate employment of the 
article, in the days of its greatest celebrity. 

42 



650 POKEROOT. 

Dr. Rowbotham has an article in the London Lancet for Sep- 
tember, 1857, on the efficacy of phosphorous acid in asthma. 
An ounce of the acid was added to a pint of spring-water, and 
of the solution two ounces were taken three times a day. In 
three days the symptoms were decidedly improved, and in a 
short time the patient resumed his trade. 

The editor of the Lancet regrets that Dr. R. forgot to give his 
formula for preparing the acid. 

My own experience in its use has been limited ; but I feel very 
much inclined to the belief that it is one of the medicines that 
could be dispensed with. 

Dr. R. M. Glover, who appears to be very partial to the use of 
phosphorus, gives some sensible hints touching the safest mode 
of exhibiting the remedy. He says he has given the article, in 
the shape of a solution, in chloroform and also in cod-liver oil. 
Chloroform dissolves one-fourth of its weight of phosphorus, 
the solution being incombustible. Four or five drops of the solu- 
tion, shaken with a drachm of sulphuric ether or a wineglassful 
of old port, were given twice a day in cases of typhoid fever, with 
obvious benefit, the forces of the system being thus sensibly 
rallied. The solution in the oil is made by cutting the phos- 
phorus into very small bits (under water of course) and adding 
half a grain to the ounce of oil. The bottle must be dipped in hot> 
water and shaken gently, so as to effect solution. In scrofulous 
affections this solution has been very useful. — London Lancet, 
Jan. 8, 1853, and Braithwaite, p. xxvii. p. 246. 

Phytolacca Decandka. Poheweed. Porhweed. Portphysic. 
Poker oot. Red Weed. Red Night-shade. CoaTcum. Pigeon 
Berry. — All these names, and perhaps as many more, are given 
in various parts of the United States to a plant or weed that is 
most undesirably prevalent almost everywhere. It grows in 
waste grounds, hj the roadside, along old fences, and in decayed 
stumps, and anywhere else if permitted to live. Its purple stalk, 
of six or eight feet high, and its loaded bunches of black berries, 
strike the eye almost in every direction in the fall of the year. 
And if robins or pigeons are plenty in the vicinity, they may be 
seen feasting there luxuriously. The flesh of those birds is often 
tinged in every fibre with the deep color of the juice; and yet 
the game is not thrown away on that account, but eaten in large 
quantities. 

Every part of the plant is said to be medicinal ; but the root 
and the berries are the portions employed most generally. The 
roots are often obtained as large as two and a half or three inches 
in diameter, and it is by reason of the vegetable energy there 
accumulated and acted upon by the genial warmth of early 
spring, that our markets abound with the beautiful pink and 



USE OF THE BERRIES AND ROOT OF POKE. 651 

white shoots that greet us so early in the season and furnish so 
palatable a variety of greens. The shoots start up in a single 
night to the length of several inches; and if only the whitish 
pink sprouts be taken, they afford a desirable esculent that is 
relished by most persons. If the shoots are taken after they 
lose this delicate color and are actually green, they are less 
wholesome. The juice of the old root fresh dug from the earth 
is quite acrid when applied to an ulcer, and acts roughly on the 
bowels in doses of an ounce or two. 

Besides the slight escharotic action of a strong decoction of 
the root applied to an ulcer on the leg, a peculiar effect is some- 
times noticed in the face, which is deeply suffused in an instant, 
more or less fullness of the head being at the same moment in- 
duced. A strong decoction applied to an erysipelatous sore on 
my leg, in 1819, gave both the results just named. 

The juice expressed from the full-grown leaves of the poke- 
weed, and slowly inspissated in the sun, furnishes an excellent 
extract for ordinary scaly tetter ', such as often affects the joints 
of the fingers. A few applications night and morning, preceded 
by proper evacuants of the stomach and bowels, will frequently 
prove effectual. The remedy is a very old one, and well known 
to the common people in various sections of our country. 

A decoction of the roots as strong as it can be made is a 
valuable remedy for many affections of the skin, and especially 
such as are associated with a troublesome itching. It is always 
necessary in such cases to correct the state of the digestive 
organs, which can often be suitably done by one or more doses 
of an emeto-cathartic, as calomel and ipecacuanha. I have 
treated the itch in this manner with marked success. I was one 
of the attending physicians of the Children s Asylum many 
years ago, when it was located in Southwark, and found it im- 
practicable to cure the disease by the sulphur ointment, which is 
so fashionable an expedient everywhere. The difficulty of keep- 
ing the clothing clean when that article was employed, and other 
objections, induced me to substitute a bath of the poke decoc- 
tion, made in quantity sufficient to fill a barrel two-thirds full. 
The children, entirely naked, were placed in the barrel, kept there 
and well rubbed for the space of ten minutes ; on being removed 
from the bath and wiped dry, a fresh suit of clothing was put 
on, and the cast-off garments carried to the washhouse. If there 
was much abrasion of the skin, the decoction gave some pain and 
always more or less uneasiness ; but it was rarely necessary to 
repeat the bath more than once. 

The juice of the berries, a tincture of the berries, and the 
dried fruit have been employed from the earliest history of 
America, in the treatment of rheumatism, particularly the 



652 PILLS — HINTS RESPECTING. 

chronic variety. A tablespoonful of the juice with half as much 
brandy is a common dose. The tincture is very little different 
from this dose. The best mode of preparing it is to fill a bottle 
with the ripe berries, loosely packed, and to pour in as much 
brandy or alcohol as the vessel will hold. A tablespoonful of 
such a tincture is the customary adult dose. I am opposed to 
either of these preparations, because of their aptitude to create 
or perpetuate a love of strong drink ; and if the berries be really 
medicinal, they can accomplish the desired objects apart from 
alcohol. From ten to twenty of the dried berries, taken four or 
five times a day, are supposed to exert an alterative agency, and 
are taken by rheumatic patients, with salutary results. From 
five to ten grains of the powdered root, with from three to five 
of ipecacuanha, taken every three hours, will answer about as 
well. 

An over-dose of the powdered root proves emetic and cathartic ; 
and if still larger, it may act as an irritant or narcotico-acrid 
poison. An infusion of the leaves or root made with hot water 
acts kindly as a remedy for piles, frequently applied to the parts. 

The Italians are reported to have employed with great success 
the following preparation in scrofula and syphilis. Boil half a 
bushel of pokeroot in a bushel of water to two gallons Of this 
very strong decoction a teaspoonful was considered a dose, which 
was given every hour till vertigo was induced. The medicine 
was supposed to act very much like veratria. 

Thatcher, in his Modern Practice, states that the early hunters 
of Missouri found an effectual remedy for the bites of rattle- 
snakes in pokeroot boiled to a soft pulp and laid on the wound 
in the form of a poultice. 

PiLULiE. Pills. — Next to powders, the pill form may be re- 
garded as the best mode for exhibiting medicine internally. And 
yet we find persons who cannot, or think they cannot, swallow a 
pill. Those individuals have no difficulty in gulping down whole 
cherries, several at once it may be. In the season of cherries, 
therefore, squeeze the stone gently out and slip the pill in, and 
thus it can be taken. 

Pills can generally be so prepared as to conceal any unpleasant 
taste. They may be coated with wafer, or with silver or gold 
leaf, or rolled in liquorice root powder, or fine starch and sugar 
mixed well together. 

Pills are sometimes preferable to powders, because gradually 
soluble in the stomach and less likely to irritate that organ. 
Many substances can not be given in solution, and often a tinc- 
ture is objectionable. In such cases, pills are to be preferred. 

It is sometimes important to exhibit hard and very dry pills. 
An irritable stomach will receive an old opium pill when it rebels 



FORMULA FOR PILLS. 653 

under the irritation of one just made. The former is very slowly 
acted on and dissolved, the latter speedily; hence the diversity 
in operation. A dry, hard pill is occasionally important because 
of its indigestibility. The common beeswax has been exhibited 
in pill form, in chronic diarrhoea, with good effect on this account. 
It proves a perpetual but mild stimulant to the mucous mem- 
brane of the bowels, and passes out unchanged. 

To keep pills from running together and cohering, they should 
be well prepared, and then kept in boxes containing a sufficient 
quantity of fine starch, or calcined magnesia, or fine powder of 
liquorice root. 

Pills made of vegetable matters should not weigh over five 
grains, because they would be too bulky. If composed of me- 
tallic and ponderous matter, six or more grains may not be too 
much. Magnesia and calomel are very opposite in regard to 
specific gravity, and may serve as illustrations, although the 
first is not a vegetable matter. For making some of the metal- 
lic salts into well-formed pills that will retain their shape, I 
know of no article so proper as the soft extract of quassia or 
gentian.* 

We present the following prescriptions for pills that will be 
found useful to the practitioner: — 

Pills of Aloes and Iron. 2. R. — Rad. scill. grs. vi; 

1. R.— Aloes spicat. ^iss; Fol. digital, grs. xij ; 

Myrrh* opt. pulv. gij ; Cal. ppt. grs. vi ; 

Extract gentian, ^iv; Pulv - myrrhae, £i; 

Ferri sulph. ^ij ■ ^ u ^ ' vve ^ together, and add 

Mellis, q. s". ' Gum fetid > 3 SS '> 

To make one hundred and twenty Ext ' S entian moL * s ' 

pills. The dose for an adult is from To make twenty pills, one to be taken 

two to four a day. morning, noon, and night. 

2. R.— Ferri sulph. Anodyne Pills. 

Sub. carb. pot. aa ni ; 

Pulv. myrrhse, zi; %• R-— Pulv. camph. grs. iij ; 

Pulv. aloes, zss. Nit. potass, grs. vi ; 

Mix, and divide into thirty pills. Ext hyosciam. grs iij ; 

Two or three at bedtime will be a Sulph. mor P h - «*• * ; 

proper dose. S ^ kmon ' * s ' 

To make three pills, to be taken at 

Alterative Pills. bedtime. 

1. R. — Mass pill, hydrarg. 2. R. — Pulv. opii, !^ss ; 

Cal. ppt. aa ^i ; Ext. hyosciam. ^iiss ; 

Sapon. Cast, gss; Sapon. dur. 

Ext. taraxaci, ^iij. Pulv. rad. glycirr. aa gi. 

Mix well, and divide into sixty pills, Mix well, and divide into sixty pills, 

of which take two or three twice a day. One to three make a dose. 

* The hardness of pills is often an objection to their exhibition with success. 
To prevent this, M. Thibault advises the use of honey in the preparation of pill 
masses. He says they will keep soft no matter how long on hand. — Bulletin de 
Therapeutics, 1857. 






654 



FORMULAE FOR PILLS. 



3. R. — Ext. lactucar. £i; 

Ext. hyosciam. gss. 
Mix to make thirty pills. Two make 
a dose. 

Anodyne and Aperient Pills. 

1. R. — Pulv. ipecac, grs. x; 

Ext. colocynth. gi ; 

Ext. hyosciam. gss ; 

Mass hydrarg. ^i; 

Sapon. Cast. grs. x; 

01. caryoph. ffyv. 
Rub well together, and divide into 
thirty pills, of which from two to five 
will be a dose. 

2. R.— Pulv. Doveri, gi ; 

Ext. hyosciam. £ij ; 

Ext. colocynth. comp. gi. 
Rub well together, and divide into 
sixty pills. From one to four will be 
a dose. 

Alterative Antimonial Pills. 

R. — Pulv. antimon. tart. grs. v; 
Flor. sulph. gij ; 
Pulv. camph. $i; 
Ext. taraxaci, giiiss. 
Mix well to make a mass, and divide 
into a hundred pills. Two or three 
may be taken three times a day. 

Compound Aperient Pills. 

1. R. — Mass hydrarg. coerul. gi ; 

Pulv. aloes opt. gij ; 
Pulv. gamboge, ^ss ; 
Pulv. myrrhae, £)ij ; 
01. caryoph. i\\v. 
Mix well, and divide into sixty pills. 
Take from one to three twice a day. 

2. R. — Pill, mass hydrarg. ^i ; 

Pulv. antimon. tart. grs. v; 

Ext. jalap, gij ; 

Sapon. Cast, $i. 
Rub intimately, and divide into sixty 
pills. Take from one to three twice a 
day. 

Antispasmodic Pills. 

1. R.— Gum fetid, ^ij ; 
Gum ammoniac, 
Gum myrrhae, 
Pulv. camph. aa gss ; 
Tinct. opii acet. gi. 
Mix well, and divide into sixty pills. 
Dose, from one to three. 



2. R. — Pulv. camph. sji; 
Nit. potass, ^ss ; 
Pulv. digital, ^ij ; 
Sulph. quin. 
Ext. hyosciam. aa ^i ; 
Syr. simp. q. s. 
To make sixty pills. From one to 
three will be a dose. 

Compound Pills of Nitrate of Silver. 

1. R. — Argent, nitrat. grs. iv; 

Ext. belladon. 
Ext. glycirrh. aa £i. 
Rub well, and divide into forty pills. 
One to three for a dose twice a day. 

2. R. — Argent, nitrat. pulv. grs. v; 

Pulv. opii, grs. x; 

Pulv. camphor, 

Nucis moschat. aa ^ij ; 

Pulv. gum Arab, gss ; 

Syr. simp. q. s. 
To make thirty-six pills, of which 
from one to three may be taken three 
times a day. 

3. R. — Argent, nitrat. pulv. grs. v; 

Sulph. quin. ^ij ; 
Sulph. morph. grs. iv ; 
Cons, rosar. q. s. 
To make forty pills. Dose, one every 
four hours for diarrhoea in low fever. 

Arsenical Pills. 

R. — Acid arsenious, grs. ij ; 
Pulv. opii, grs. viij ; 
Sapon. Cast. grs. xxxvi. 
Mix, and divide into twenty-four 
pills. Dose, one three times a day. 

Compound Arsenical Pills. 

R. — Acid arsenious, grs. ij ; 
Sulph. cupri. grs. xij; 
Sulph. quin. grs. xxiv; 
Cons, rosar. q. s. 
To make twenty-four pills. Dose, 
one three times a day. 

Compound Fetid Pills. 

1. R. — Gum fetid opt. £i ; 
Sulph. quin. gss; 
Sapon. dur. ^ss; 
01. pulegii, iflx ; . 
Syr. simp. q. s. 
To make forty-eight pills. Take 
three or four night and morning. 



FORMULA FOR PILLS. 



655 



2. R.— Gum fetid, 

Pulv. valerian, aa ^ss ; 
Gum camph. grs. x ; 
01. cajeput. q. s. 
To make thirty pills. Take two or 
three for a dose at bedtime. 

3. g.. —Gum fetid, 

Pulv. valerian, aa sji ; 
Ext. aconiti, grs. vi; 
Pulv. scill. grs. x ; 
Carb. ammon. grs. xv; 
Syr. zingib. q. s. 
To make forty-eight pills. Two to 
four make a dose. 

Compound Camphor Pills. 

1. R. — Pulv. camph. grs. iv; 

Nit. potass. £)ij ; 
Antim. tart. grs. ij ; 
Pulv. glycirrh. Qij ; 
Mellis, q. s. 
To make eighteen pills. Dose, one 
to three, three times a day. 

2. R. — Pulv. camph. grs. iij ; 

Pulv. ipecac, grs. vi ; 
Ext. hyosciam. ^ss; 
Syr. simp. q. s. 
To make five pills. Two make a 
dose. 

3. R. — Pulv. camph. grs. xv; 

Nit. potass, ^ij ; 
Antim. tart. gr. i ; 
Cons, rosar. q. s. 
To make ten pills. One to be taken 
every four hours. 

Cathartic Pills. 

1. R. — Pulv. gamboge, 

Pulv. aloes, 
Pulv. scammon. 
Pulv. rhei, aa ^i ; 
Oxymel scillse, q. s. 
To make sixty pills. Dose, two to 
four at bedtime. 

2. R. — Ext. colocynth. comp. ^i; 

Pulv. aloes opt. gss ; 
Ant. tart. grs. iv ; 
Sapon. dur. 7)i; 
01. caryoph. ^i. 
Rub well together, and divide into 
sixty pills. One to three make a dose. 

3. R. — Ext. juglan. cath. ^ij ; 

Ext. colocynth. comp. ^i; 
Pulv. ipecac. $ij ; 
Pill, mass hydrarg. gi. 



Rub intimately, and divide into eighty 
pills. From one to three may be a dose. 

4. R.— Cal. ppt. ^i; 

Pulv. jalap, :£ss ; 
Pulv. rhei, gi ; 
Ant. tart. grs. iv; 
Cons, rosar. q. s. 
To make sixty pills. Take from two 
to four at bedtime. 

5. R. — Pill, mass hydrarg. gij ; 

Ant. tart. grs. v; 
Sapon. Cast, ^i; 
Pulv. aloes opt. gi; 
Gum fetid, gss. 
Rub well, and divide into sixty pills. 
Dose, from one to three at bedtime. 

6. R. — 01. croton tigl. £ss; 

Pulv. opii, 

Pulv. ipecac, aa grs. x ; 
Cons, rosar. q. s. 
To make ten pills. Dose, one every 
four hours. 

7. R. — Ext. colocynth. comp. giv; 

Cal. ppt. p. ; 
Ant. tart. grs. v. 
Mix intimately, and divide into sixty 
pills. One to three for a dose. 

Pills of Blue Vitriol and Opium. 

R. — Cupri. sulph. grs. vi; 
Pulv. opii opt. grs. iv ; 
Pulv* tragacanth, j^i ; 
Muc. gum Arab. q. s. 
To make twelve pills. Take one 
three times a day, in chronic diarrhoea. 

Deobstruent Pills. 

1. R. — Hydrarg. cum creta, grs. xvi ; 

Sodse carb. exsiccat. ^i; 
Ext. taraxaci, ^i. 
Mix well, and divide into twenty pills. 
Take two or three every night. 

2. R. — Ant. tart. grs. v; 

Sapon. venet. ^ij ; 

Pulv. gum Arab, gi ; 

Mass pill. hyd. ^ss. 
Mix intimately, and divide into forty 
pills. Take three, morning and evening, 
for cutaneous eruptions. 

3. R. — Cal. ppt. grs. vi; 

Ant. tart. gr. i ; 
Ext. taraxaci, grs. x. 
Mix well, and divide into four pills. 
Take one night and morning. 



656 



FORMULA FOR PILLS. 



Diuretic Pills. 

1. R.— Pulv. scillee, grs. ij ; 

Pulv. digital, gr. i; 

Pill, mass hydrarg. grs. yi ; 

01. juniperi, TT[ iv 5 

Pulv. ipecac, grs. vi. 
Mix well, and divide into four pills, 
of which two will be a dose at bedtime, 
followed by some warm mild drink. 

2. R. — Potass, bi-tart. gi; 

Sodee bi-bor. ^iss ; 
Pulv. rad. seneg. gi; 
" colchici, ^ij > 
" scillse, grs. xvi; 
Ext. taraxaci, giij. 
Mix carefully, and divide into one 
hundred pills. The dose will be three, 
three times a day. 



Emmenagogue Pills. 



1. R. 



-Pulv. aloes soc. 

myrrhse, aa giss ; 
gum ammoniac, £i ; 
sodae bi-bor. ^iss ; 
ferri sulph. gss ; 
ferri carb. "$i; 
rhei, ^ij ; 
01. sabinae, ^i ; 
Sapon. q. s. 
To make one hundred and twenty 
pills. Dose, two or three, three or four 
times a day, in feeble habits. 

2. R.— Ferri lact. 
Ferri sulph. 
Ferri carb. aa gi ; 
Ext. taraxaci, ^ij ; 
Pulv. canthar. grs. xx. 
Rub well together, and divide into 
one hundred pills. Dose, one, three or 
four times a day, for feeble habits. 

Pills of Iodide of Iron. 

R. — Ferri iod. gss; 

Pulv. croci, gi; 

Sacch. alb. giij ; 

Muc. gum Arab. 

To make ninety pills. Take one, 

two, or three, several times a day. 

Pills of Nux Vomica. 

1. R. — Ext. nucis vomic. 9ss; 
Gum fetid, giss ; 
Syr. simp. q. s. 
To make thirty pills. Take one two 
or three times a day. 



2. R. — Ext. nucis vomic. grs. ij ; 
Morph. acet. gr. i ; 
01. olivar. grs. x; 
Dissolve, and add 

Ext. helleb. nig. ^i; 
Pulv. glycirrh. grs. viij ; 
Mellis, q. s. 
To make twelve pills. Take one, 
two or three times a day, for chlorosis 
and amenorrhoea. 

Sugar of Lead Pills. 

1. R. — Plumbi acet. grs. viij ; 

Pulv. opii, grs. iv ; 
Cons, rosar. q. s. 
To make eight pills. Dose, one, two, 
or three, according to circumstances. 

2. R. — Plumbi acet. grs. iv; 

Pulv. digital, grs. vi; 
Pulv. opii, grs. iij ; 
Cons, rosar. q. s. 
To make six pills. Dose, one three 
times a day. 

3. R. — Plumbi acet. grs. xij ; 

Acet. ext. colchic. grs. xv; 

Pulv. opii, grs. iij ; 

Muc. gum Arab. q. s. 
To make twelve pills. One for a 
dose, to be repeated as occasion may 
require. 

Compound Pills of Squill. 

1. R. — Pulv. scillse, gss; 

" gum ammoniac, 
" succ. glycirrh. aa gi; 
" ant. tart. grs. v; 
" nucis mosch. Qi; 
Syr. limon. q. s. 
To make fifty pills. Two or three 
may be taken three times a day. 

2. R.— Pulv. scillse, 

" zingiber, aa gi; 

" ipecac, gss; 
Sapon. Cast, ^iss; 
01. juniperi, TT[xxx. 
Mix, and divide into forty pills. 

Aperient Tonic Pills. 

1. R. — Quin. sulph. £i ; 
Ext. gentian, gij ; 
Pulv. aloes, 
Pulv. myrrhae, aa £i ; 
Syr. simp. q. s. 
To make one hundred and twenty 
pills. Take two or three, three times 
a day. 



FORMULA FOR PILLS — ALLSPICE. 657 

2. R._ Quin. sulph. v}i; To make forty pills. One to three 

Pulv. aloes, ^ss ; for a dose in leucorrhoea, gleet, &c. 

Ext. gentian 3 i. Tonic Zinc Fills. 

Mix, to make twenty-four pills. Dose, _ _. . . . _. 

one three or four times a day. R.-Zmci sulph. £i ; , 

Ext. gentian, 31 ; 

3. R.— Ferri sulph. Quin. sulph. gss. 

Quin. sulph. aa ^i; Mix> to make forty pills> Take two 

Ext, gentian L _ _ three QY foup times a d 
Pulv. aloes, aa ^iss ; 

Syr. simp. q. s. Compound Zinc Pills. 
To make eighty pills. Two, three, 1. R. — Zinci sulph. grs. xij ; 

or four will "be a dose. Pulv. myrrhse, gi ; 

4. R._Quin. sulph. _ " iP ec ^ c - Z™ ™j 5 

Pulv. aloes, aa Bij ; ^xt. h 7 0SCiam - ^ '> 

Ext. quass. 5 iss ; Syr. simp. >q. s. 

Syr. simp. q. s. To make thirty pills. Dose, from 

To make fifty pills. Two or three one to four a da ^ 

for a dose. 2. R. — Zinci sulph. grs. xij ; 

Pulv. ipecac, grs. vi; 

Tonic Copper Pills. " myrrhse, ^ij ; 

R.— Cupri. sulph. grs. x; Lactucarii, 51; 

Pulv. rhei, gi ; Syr. simp. q. s. 

Ext. quass. gij ; To make thirty pills. One three 

Syr. simp. q. s. times a day. 

Pimenta. Pimento. Myrtus Pimenta. Jamaica Pepper. 
Allspice. The berries of the plant. — The tree grows abundantly 
in the West Indies, and especially in Jamaica. As everybody 
knows what allspice is just as well as we do, and perhaps better, a 
description is not desirable. Ground or powdered allspice alone, 
or united to other spices, and made into infusion or decoction, 
will be found a good fomentation, and is rubefacient. Internally, 
the powder and infusion are employed as a stimulant and car- 
minative. The habitual chewing of the article, though a better 
practice than tobacco eating, is often pernicious to the right per- 
formance of the digestive function. 

Piperis Nigri Baccle. Black Pepper. The berries. — The 
plant is largely cultivated in Java, Sumatra, &c, whence the 
berries, known as pepper, are largely obtained. We need not 
attempt a description of that which every one has seen and tasted 
a thousand times. 

Black pepper is among the most ancient remedies for ague and 
fever ; but in order to be successful it has been said that you 
must swallow nine whole grains at once, for nine days in succes- 
sion. The proximate principle, piperine, has had considerable 
repute in the same disease, sometimes alone, but more frequently 
combined with sulphate of quinine. I have employed it, chiefly 
in low fevers of a typhoid aspect, in union with the quinine salt. 
The ordinary dose is from five to ten grains, which prove stimu- 
lant and diaphoretic. 



658 MASTIC — TAR. 

Dr. Hartle, of the West Indies, speaks in high terms of pipe- 
rine in intermittents. As soon as the sweating stage was esta- 
blished, he gave three grains of piperine every hour until eighteen 
grains were taken. On the next day, during complete intermis- 
sion, he gave the same dose every three hours. He affirms that 
this practice was always successful. After the disease was 
arrested, he gave a pill every morning, noon, and night, com- 
posed of a grain of blue mass, two grains of piperine, and two 
of the sulphate of quinine, mixed with a small portion of syrup. 
This completed the cure, by correcting any derangement of the 
liver and by the continued action of the antiperiodic. I have no 
doubt that the practice would be efficacious in preventing a re- 
lapse if rigidly adhered to until midwinter. 

An infusion of black pepper in vinegar and ardent spirit is fre- 
quently employed as a gargle for the relief of sore throat. A 
poultice of bread and milk, with fine powder of pepper, is a very 
good discutient. 

Pistacia Lentiscus. Mastic. — This article has been intro- 
duced to our notice as a hemostatic of great worth. Dr. Frank- 
land Terzer, a Vienna dentist, has used it in epistaxis and other 
haemorrhages following the extraction of teeth. These are often 
alarming, and demand prompt attention. The tincture is applied 
by a hair pencil to the bleeding part. Leech-bites often bleed 
profusely, and this application promptly arrests the flow of blood. 
The tincture may be made by digesting an ounce or two of the 
mastic in a pint of alcohol or strong brandy. 

Pix Liquida. Liquid Pitch or Tar. Obtained from the 
Pinus sylvestris, or Scotch fir. — What is called black pitch is 
merely inspissated tar. Liquid pitch or tar is prepared by a kind 
of distillation of the wood of the fir, cut into small billets, and 
piled in a heap covered with turf, which is set on fire and burned 
slowly, a very small quantity of air being admitted. During the 
process the tar runs off at the bottom of the pile and is collected 
in barrels. 

Tar-water has long been in use, though very variously esti- 
mated. The simplest mode of preparation is to pour half a gallon 
of boiling water on half a pint of tar. The water acquires an 
empyreumatic odor, a slightly-yellow tinge, and may be drank 
without restriction. 

The London Lancet for January, 1843, gives the following as 
the best mode for making strong tar-water : — Take three ounces of 
tar, a drachm and a quarter of carbonate of magnesia, mix them 
together and add a pint of boiling water. Shake, and then boil 
for a few minutes, filter, and add forty-five drops of vinegar. 

Tar-water is diuretic, diaphoretic, and expectorant, when drank 
freely and for some time. It is probably always safe, though 



LEAD. 659 

not quite entitled to all the encomiums heaped on it by Bishop 
Berkley, who regarded it in the light of a panacea. 

Mr. Duhamel gives a formula for tar beer in the American 
Journal of Pharmacy, vol. vi., as follows : — 

Put one quart of bran, 
one pint of tar, 
half-pint of honey, 
three quarts of water 

into a new pipkin, simmer over a slow fire for three hours, then 
cool, and add half a pint of yeast. After standing for thirty-six 
hours, strain, and it will be fit for use. The dose is a wineglass- 
ful before each meal. This beer is said to be much more highly 
charged with the volatile principles of tar than the aqua picis. 

Tar ointment is sometimes employed alone, or with sulphur, as 
a remedy for cutaneous eruptions. 

The water has long been resorted to by females to prevent the 
nipples from being made sore by the sucking of the infant. For 
this end the nipples are washed, and also a considerable part of 
the breast, three times a day for three months before expected 
delivery. 

A plaster of tar as large as the injured spot is an old remedy 
for burns and scalds. 

Plumbum. Lead. — This is not employed in the metallic state, 
except in the form of sheet-lead, as a dressing to ulcers, and as 
a means of making pressure on tumors. Its specific gravity is 
11.5 ; it melts at 600° ; is soft, flexible, ductile, and malleable. 
All the compounds of lead are poisonous, and some of them use- 
ful as medicines. 

The preparations of lead most generally known, are the semi- 
vitrified oxide or litharge, the carbonate, acetate, and subacetate. 

The basis of all the salts of lead is the protoxide, composed 
of one equivalent of oxygen and one of lead. It may be formed 
by exposure of the film that collects on fused lead to a heat 
sufficient to give it a uniform yellow color, and is then known as 
massicot. When the heat is pushed further, so as to fuse the yel- 
low matter, it is changed into a scaly substance, having a mixture 
of red and yellow, owing to the formation of a little red oxide. 
The product is what we call litharge. This substance enters into 
the composition of lead plasters, Goulard's extract, &c. &c. 

Litharge, intimately mixed with sweet oil, forms a liniment 
that has been very successful in the management of itch. Dr. 
Lison, of the hospital of Donzi, speaks in high terms of it. The 
proportions are an ounce of litharge to four ounces of oil, which 
should be slowly heated over a moderate fire and frequently 
stirred, until the mass acquires a blackish tinge. A half-ounce 
should be smartly rubbed on the hands, feet, and arms night and 



660 SUBACETATE OF LEAD. 

morning. If the parts are very much abraded, there is danger 
of this application, unless the bowels be kept regularly open 
every day. 

What has been called subacetate of lead is made thus : — Mix 
and boil two pounds of litharge and a gallon of diluted acetic 
acid to six pints, taking care to stir constantly ; and when the 
articles are thoroughly incorporated, set aside to settle, and then 
filter the liquor. The solution is also called diacetate of lead, 
because it contains two equivalents of protoxide to one of acid. 
Others have called it the triacetate, and some prefer the terms 
subacetate and G-oulard's extract of lead. It has a pale-yellow 
color, and of a darker tinge if made of colored vinegar. 

We have given the terms subacetate of lead and Goulard's ex- 
tract as synonymous, and so they are generally regarded ; but 
the latter is, more properly, the former diluted with distilled 
water. Both present good sedative and astringent applications, 
and are employed externally. The degree of dilution is to be 
regulated by the particular case to which it is to be applied. A 
pint of pure water and half a drachm of the subacetate will 
make a good wash for many purposes. The strong solution of 
the subacetate is sometimes employed in making cerates, as the 
compound lead cerate. Thus : — 

Take of subacetate of lead, two and a half ounces ; 
Yellow wax, four ounces ; 
Olive oil, nine ounces ; 
Camphor, half a drachm. 

Mix the melted wax with eight fluidounces of the oil, and, 
having removed the vessel from the fire, add slowly the solution 
of subacetate of lead, constantly stirring with a wooden spatula 
until the whole is cold ; lastly, mix the camphor dissolved in the 
balance of the sweet oil. 

A good cerate may be formed by rubbing a little of the sub- 
acetate with simple cerate ; or by rubbing with the cerate some 
fine powder of sugar of lead. 

The common lead plaster is made thus : — Take of fine litharge 
five pounds, sweet oil a gallon, water a quart. Boil these over 
a gentle fire, stirring constantly, till the ingredients acquire the 
consistence of plaster. This is the basis of several useful plas- 
ters known to the profession. The common adhesive plaster is 
made by melting half a pound of powdered rosin with three 
pounds of lead plaster. It is spread on linen or sheepskin for 
use, and has been found a good application to burns and scalds, 
by excluding the air from the very sensitive surface. 

The Goulard's extract named above has been recommended as 
an application to small, non-pulsating ncevi materni. It is applied 
cold, by means of compresses dipped in the solution and bound 



CARBONATE OF LEAD. 661 

to the part. The cuticle soon separates, cracks, and falls off, 
after which the application is to be renewed. In about four 
weeks the cure is complete. — Edinburgh Medical and Surgical 
Journal, April, 1843. 

Carbonate of lead, cerusse, ivliite lead, subacetate, carbonate 
of protoxide of lead are names given to the same article, 
which may be formed in several ways. The commercial white 
lead is prepared by exposing coils of sheet-lead to the vapors 
of vinegar, as they issue from pots placed in tan and other 
matters capable of heating the vessels moderately. The lead 
is oxidated, and the oxide absorbs carbonic acid from the atmo- 
sphere, so forming the carbonate. The white coating of the 
lead is scraped off into vessels containing water, and being in- 
soluble, falls to the bottom. 

The carbonate is sometimes applied in very fine powder to 
excoriated surfaces, and although it may do good it may also do 
mischief. It is hardly a safe application, and should never be 
employed unless the bowels are kept in rather a loose state. It 
is used also in the shape of white-lead paint, which is a sort of 
liniment of the carbonate, as an application to piles, and we are 
► assured with good results. A drachm of dry white lead and an 
ounce of lard or simple cerate make a mixture very little different. 

It is the carbonate of lead that most usually induces that ob- 
stinate and often fatal disease called lead colic, colica pictonum, 
painter s colic, &c. &c. Painters make very large use of white 
lead, not only to paint white, but as the basis of other colors ; and 
Professor Cozze has shown that the lead, as a salt or oxide, 
enters the blood. — Edinburgh Medical and Surgical Journal, 
October, 1844. The surest preventive of lead poison is the 
free use of oleaginous matters, as sweet oil and sulphuric acid- 
lemonade, (see Acid, sulphuric,) by those who work in the metal 
or its salts. 

We named the use of the carbonate as a remedy for piles, and 
now suggest the following : — 

Take of carbonate of lead, ^ss ; 
Sulphate morphia, grs. xv; 
Ung. stramon. 25 i; 
Sweet oil, q. s. to form an ointment. 

A piece as large as a nutmeg should be applied to the tumors 
at bedtime, after washing with soapsuds. 

An ointment, made by rubbing the dry white lead with lard, 
has long been in use as a remedy for burns and scalds. Profes- 
sor Gross speaks favorably of the common white-lead paint for 
the same purpose, yet I am of opinion that we have less question- 
able resources. A case is given by Dr. Kunkler, of Madison, 
Indiana, in the July number of the North American Med. -Chi- 



662 SUGAR OF LEAD. 

rurg. Rev., showing that lead colic was induced by treating a 
case of scald with this remedy. Prof. Gr. observes (in notice of 
the case) that it is the first of the kind he has heard of, and that 
all the symptoms so induced can be readily removed by the free 
use of the elixir of vitriol. 

The most important preparation of lead is the well-known 
acetate, or sugar of lead, or saccharum Batumi of the old 
writers. It has been called superacetate, though improperly. 
This salt, composed of one equivalent of acetic acid and one of 
protoxide of lead, is made by dissolving the protoxide in dis- 
tilled vinegar and boiling the solution. The operation should be 
carried on as long as the acid will take up any portion of the 
protoxide. The solution is then to be filtered and evaporated 
until a pellicle appears and the liquor cools ; crystals of sugar of 
lead are deposited. These crystals have a sweetish styptic taste, 
and the mass looks a little like white sugar. The crystals are 
readily soluble in water, which is apt to make the solution turbid, 
because of the presence of carbonic acid in the water. If the 
water be well boiled the solution will be clear. 

The incompatibles of sugar of lead are alkalies, alkaline 
earths, acids, alum, borax, sulphates, muriates, soaps, sulphurets, * 
emetic tartar, solutions containing carbonic acid, &c. &c. 

Some practitioners employ a mixture of sugar of lead and 
alum in watery solution, supposing thereby to have a powerful 
astringent. But the mixture is decidedly incompatible, and the 
medicinal power of both ingredients is lost. For the same 
reason, sugar of lead and white vitriol are incompatible. And 
this doctrine helps us to meet poisoning by sugar of lead very 
completely, for we cannot employ a better antidote than sulphate 
of magnesia. The meeting of the two salts gives rise to an in- 
soluble and inert sulphate of lead. The magnesian sulphate dis- 
solved in water should be exhibited copiously. It has been said 
that creosote has a decided power in controlling the poisonous 
action of sugar of lead ; but I should prefer the Epsom salt. 

The principle of incompatibility referred to makes it wrong to 
give our patients diluted elixir of vitriol when they are under 
treatment by sugar of lead, because we risk the destruction of 
this salt and the formation of an insoluble sulphate. As a safe 
rule, no sort of drink should be allowed, excepting cold water or 
vinegar and water. 

Acetate of lead is extensively employed as a sedative, and as 
an astringent, externally and internally. We apply it to in- 
flamed surfaces in watery solution, or in form of lead-water 
poultice. This is made by soaking fine crumb of bread in a strong 
solution of the acetate, or a solution containing at least a drachm 
of the salt in a pint. About five grains dissolved in an ounce or 



USES OF SUGAR OF LEAD. 663 

two of rose-water will give a good wash for inflamed eyes, which 
may be weakened or made stronger as circumstances may 
suggest. Similar solutions are made for the treatment of gonor- 
rhoea, but they are often so strong as to induce hernia humoralis, 
or swelled testicles. 

A physician in Georgetown, District of Columbia, treated 
chilblains with a mixture of sugar of lead, citrin ointment, &c. 
Thus :— 

R. — Acet. plumb, gij ; 
Ung. citrin, ^i ; 
Spt. terebinth, gij. 

Mix the sugar of lead and turpentine well together, add the 
citrin ointment, and rub the whole so as to make a homogeneous 
mixture. Anoint the parts night and morning with this oint- 
ment, making use of smart friction. It is stated that the itch- 
ing and burning soon subside. 

Dr. McFadzen, of Edinburgh, found sugar of lead very effica- 
cious in the treatment of tinea capitis. The head having been 
shaved and well washed with soapsuds, he applied a large com- 
press of lint wet with a solution of three grains of sugar of lead 
in an ounce of water. The lint was wet three times a day, and 
the whole covered with an oiled-silk cap. 

In hemorrhages of almost every variety, sugar of lead has 
long been employed, sometimes alone, but often with the addition 
of opium, and it is held to be a very valuable medicine. The 
late Prof. Dewees was highly instrumental in establishing the 
safety and success of the remedy in uterine hemorrhage ; but it 
was introduced, as we learn from vol. iii. of the Medical Trans- 
actions of the London College of Physicians, by Dr. Reynolds, 
in the year 1780. The dose may vary from two to ten grains 
every half-hour, or every hour, and it need not be conjoined with 
' an opiate unless spasm of the stomach or some other contingency 
should occur to make it proper. In that case a grain of opium 
or a quarter-grain of the acetate of morphia might be added 
occasionally. 

Dr. Nasse, a German, employed the acetate in the disease 
called dothinenteritis, a fever of low type, attended with follicu- 
lar ulcerations of the small bowels, the same affection that is 
often designated as typhoid fever. He says he succeeded in 
seventeen cases, with doses varying from a half to a third of a 
grain from three to six times a day. In eight very debilitated 
patients he combined the acetate with carbonate of ammonia. 
Another German physician cites fifty cases in which he employed 
the acetate of lead with great success. 

To all this presumed success of sugar of lead in the disease 
named by Dr. Nasse, we take the liberty of entering our caveat. 



664 USES OF SUGAR OF LEAD. 

Not that we mean to deny the fact that so many of the doctor's 
patients recovered, for that is quite probable; but we demur, 
when it is taken for granted that a state of the bowels existed in 
the patients the proof of which never was made, and never can 
be, save by the knife. The patients named got well, however, 
and of course dissection was not made a test ; and we affirm that 
there is no other. You may conjecture, but not a symptom nor 
a collection of symptoms can infallibly prove the presence of 
dothinenteritis during life. 

In a paper published in the Edinburgh Medical and Surgical 
Journal, vol. xxvi., Dr. Burke affirms that a solution of sugar of 
lead and laudanum was very salutary in his hands in the treat- 
ment of dysentery, when fever was wholly absent, and the patient 
worn out by bloody discharges and tenesmus. The prescription 
was as follows : — 

R. — Acet. plumb, grs. iv; 
Tinct. opii, gij ; 
Aquae, gij. 
Mix, and give half an ounce every four hours for a dose. 

In the last stage of dysentery such practice might be proper, 
for the continued evacuations and the whole treatment often 
leave the bowels in a relaxed condition that may justify the treat- 
ment, while it could only do harm in the early stage. 

In diarrhoea, sugar of lead has been used a great while. And 
probably an article not very unlike it was employed before this 
medicine was known to the profession. Mothers knew that shot 
boiled in sour milk gave to the liquor a quality that fitted it to 
check infantile diarrhoea. Two grains of the acetate three times 
a day, with or without opium, have frequently cured obstinate 
diarrhoea after the most potent astringents had failed. I em- 
ployed it many years ago (1824) in cholera infantum, as may 
be seen by reference to my paper in the Worth American Medi- 
cal and Surgical Journal. The close, to a child of a year old, 
was an eighth of a grain morning and evening, sometimes alone, 
and occasionally with a fraction of a grain of calomel. In 
Asiatic cholera the acetate has been a good deal employed, and 
not unfrequently with success. The usual dose is from five to 
ten grains combined with a grain or two of opium ; but some 
physicians have exhibited thirty-grain doses with manifest ad- 
vantage. 

A writer in Braithwaite, part xxiv., says he has not found any 
means so successful in cholera infantum as acetate of lead and 
opium. To an infant six months old he gave one-twelfth of a 
grain of opium, with a sixth of a grain of the acetate, after each 
discharge, up or down. 

Prof. Ebbling, of Hamburg, reported a case of what he called 



IODIDE AND TANNATE OF LEAD. 665 

pulmonary catarrh, in a woman aged sixty, cured by doses of a 
quarter of a grain of sugar of lead mixed with a scruple of sugar 
and given every third hour. Six powders arrested the disease, 
which, at the end of nine months, reappeared, and was again 
cured by three powders. This statement, which was republished 
in the New York Medical Repository for 1813, seems to be de- 
ceptive. We cannot perceive on what principle such minute 
doses of the acetate could have so promptly met such a case. 

A much more rational practice is given by Dr. Fauquier for 
the arrest of the night siveats of phthisis pulmonalis. Twelve 
grains of the acetate of lead administered at bedtime had the 
desired effect. 

The employment of sugar of lead in chorea and epilepsy is of 
ancient elate. The late Prof. Rush reports success in young epi- 
leptics with this medicine, and Prof. Eberle has given a similar 
case. 

A case of hydrophobia is reported by Dr. Smith in the Neiv 
York Medical and Physical Journal, 1826, as cured by very 
large doses of acetate of lead. The patient had taken freely of 
calomel, and was salivated without much benefit. He was then 
put on the use of sugar of lead, and in four days took three hun- 
dred and twenty grains, besides the application to the bitten part 
of four ounces of Goulard's extract. The lead induced paralysis, 
and Epsom salt was administered, probably to neutralize the 
power of the medicine. The paralysis passed away, however, 
and complete recovery followed. 

It is to be presumed that the mercurial treatment partially, 
and the lead treatment more perfectly, antagonized the poison of 
the disease, and that the result was due to that principle of 
therapeutics. 

Iodide of lead has been employed by the French in the treat- 
ment of scrofulous and scirrhous tumors. They regard it as 
better than iodine or hydriodate of potash. The iodide of lead 
is made by adding a solution of acetate of lead to a solution of 
hydriodate of potash. A yellow iodide falls, which must be well 
washed and dried on a filter. It is employed in form of oint- 
ment. 

Tannate of lead. — When a solution of sugar of lead is added 
to infusion of oak bark, a precipitate falls, which should be col- 
lected on a filter and dried. This is bi-tannate of lead, a white 
substance, possessed of decidedly astringent properties. Dr. 
Tott, of Germany, employed it in cases of low fever, with slough- 
ing of the soft parts in consequence of long confinement. Two 
drachms of the salt, rubbed with an ounce of rose ointment, con- 
stituted the unguent of Tott. Any simple ointment would 
answer equally well, and a few drops of essential oil to give a 

43 



666 POISON OF LEAD. 

pleasant odor. The ointment is to be spread on old linen and 
laid on the parts affected. The gangrenous action is arrested, 
and the ulcers soon healed. (See American Journal of Phar- 
macy, vol. iii.) 

Our concluding remarks on lead and its preparations relate 
exclusively to the poisonous action so often developed, and re- 
corded in the journals. 

Many of the more important toxicological facts in relation to 
lead are too little known to the profession ; and there are many 
physicians who do not appear to be aware that much of the dys- 
pepsia and bowel disease prevalent in our country is fairly at- 
tributable to the agency of this metal, as connected with various 
processes of cookery. The poison may be very largely diluted, 
and its operation may be slow, yet the final certainty of the per- 
nicious result is no less real. 

So many and so various are the applications of lead in domestic 
economy that it is wonderful so few accidents have followed its 
use. Even in the metallic form it may do mischief; and the 
oxides as well as the salts of lead, both by accident and design, 
have been the means of destroying many lives. 

Among the simplest forms of lead poison, we notice those seen 
in plumbers, printers, and others, who work in the metal either 
in its pure state or blended with other metals. In large cities, 
where plumbers are numerous, lead colic is very common, al- 
though these persons handle lead pipe and other forms of the 
simple metallic matter. Now and then, however, they are ex- 
posed to the vapors of the metal in a state of oxide formed by 
heat. To guard against the pernicious effects, master-workmen 
give sweet oil to their apprentices, and feed them a good deal on 
fat broths, to sheathe the stomach and bowels. 

Dr. Brice reports, in the London Lancet for December, 1842, 
a very interesting case of severe lead colic induced by swallow- 
ing, at short intervals, not less than three ounces of leaden shot, 
taken for the cure of a boil on the side, according to the custom 
of the country. Under the use of active cathartics, and the oc- 
casional employment of henbane and the warm bath, the patient 
got well. 

It appears to have puzzled the physician to account for the 
effects, inasmuch as metallic lead has been affirmed to be inca- 
pable of doing harm. It is also stated that the shot did not pass 
off, as such, in the fecal discharges. We are told, however, that 
the patient drank freely of cider, and the acid matter in that 
drink, and other acid matters present in the stomach and bowels, 
had, we doubt not, the power to oxidate the lead at least, if not to 
convert it into a salt. We see nothing wonderful in the history. 
Indeed, it would surprise us to be otherwise affected, could we 



LEAD COLIC. 667 

be so void of common sense as to swallow deliberately two or 
three ounces of metallic lead. 

Almost from time immemorial the formation of a crust on lead, 
over which water has passed, has been frequently noticed, and its 
deleterious tendency guarded against by statutes prohibiting the 
use of leaden pipes of conduit. Yet it is equally notorious that 
leaden pipes have been employed without imparting to water any 
sort of pernicious quality. This has been known for many years 
in the city of Philadelphia, where repeated examinations have 
failed to detect lead in solution. 

These diverse facts led to many experiments, from which it 
is inferred that water free of the salts usually found in spring- 
water is soon contaminated : while the presence of such salts 
destroys the capacity of the water to corrode the lead. Distilled 
water was charged by Guyton de Morveau with sulphate of lime, 
and it failed entirely to display any action on the pipes. 

It is matter of history, however, that lead colic was not known 
in Amsterdam until after the introduction of lead-roofing for the 
houses ; then it raged with violence. In 1814 many thousand 
feet of lead pipes were laid to conduct the waters of Tunbridge 
Wells to the different houses. In the next year the lead colic- 
was very prevalent, and, on examination being made, the water 
was found to hold lead in solution. On the same principle it is 
supposed, and correctly, we think, that the dry bellyache of the 
West Indies is caused. The roofs in that region are frequently 
painted, and the water falling on the surface charged with lead, 
and thence collected in tanks, constitutes the common drink and 
is employed in domestic economy. 

In vol. xix. of Medical Commentaries, we are informed of the 
production of a violent lead colic, on board a packet bound to 
the East Indies, from the use of water kept in a leaden cistern 
and furnished with a stop-cock. On arriving at St. Helena and 
obtaining wholesome water the hands gradually recovered. 

In the cases cited, there was doubtless a lack of the saline 
matters commonly found in spring-water, and hence the lead 
was acted upon. The investigations of Christison and others 
make it pretty certain that in proportion to the purity of water 
and the presence of carbonic acid gas in it, will be the corrosion 
of the metal. In all cases of the contamination of water by 
means of leaden vessels, we may show the presence of the metal 
in solution by the sulphureted hydrogen gas. It strikes a brown- 
ish color, and a precipitate finally settles at the bottom. 

To show most conclusively the effect of leaden pipes under 
some circumstances, and those not unusual by any means, the 
following account, given in Lambe's Essay on Spring-Water, 
will be found very important. " Lord Ashburnham's family, in 



668 LEAD COLIC. 

Sussex, was supplied with spring-water from a considerable dis- 
tance by means of leaden pipes. Every year the servants were 
tormented with colic, and some of them died. The water at 
length was examined by Dr. Higgins, who reported that it con- 
tained an unusual amount of carbonic acid, which acted on the 
lead and formed a carbonate. In consequence of this discovery, 
the leaden pipes were taken up and wooden ones put down, after 
which the family had no particular complaint in the bowels." 

From what has been said, we conclude that although water, in 
some regions, may be carried in leaden pipes without injury, 
yet, on the whole, seeing that this metal frequently exerts a 
deleterious agency, it would be well if it were excluded entirely 
from this use, and either iron or wood or glass employed as sub- 
stitutes. Could an accurate chemist be always found to deter- 
mine the presence of saline matters in spring-water, the lead 
pipes might be safely resorted to. Dr. Christison tells us that 
rods of lead kept in the waters of Airthrey for thirty-five days 
were unchanged, and of course the water as pure as ever. These 
waters contained a seventy-seventh part of their weights of sul- 
phates and muriates. But as it is not practicable at all times to 
procure the services of an able analyst, the safer course is to 
avoid the hazard by making use of agents that are not capable 
of doing harm. 

If water tolerably pure may be acted on by lead so as to be 
deleterious, we need be at no loss to conceive how various kinds 
of food and drink may be contaminated by the same means. Thus 
cider (which, of course, contains malic and acetous acids) may be 
converted into a source of mischief, apart from its intoxicating 
power. A gentleman had a quantity of cider on hand rather 
too sour for his use, and he supposed it might be remedied by 
boiling it with a little honey in a brewing vessel the rim of which 
was capped with lead. All who drank of the liquor thus rectified 
were seized with colic of greater or less violence. A servant, 
who perhaps drank most freely of it, died very soon, in convul- 
sions, and several others of the family were greatly distressed 
for a long time. The master of the family never recovered his 
health, but died miserably after languishing for three years, 
under disease supposed to be caused by the lead poison. — Medi- 
cal Transactions, Lond., vol. L 

The Transactions of the Provincial Medical and Surgical 
Association (England, 1842) tells us that lead colic, or Devon- 
shire colic, is now extinct in the city and neighborhood, unless 
in painters or those accidentally exposed to the vapors of lead. 
The abandonment of the use of leaden cisterns or vessels in the 
manufacture of cider has been followed by the disappearance of 



LEAD COLIC. 669 

the disease, which can no longer be called with propriety Devon- 
shire colic. 

Even milk has been injured and made to acquire insalubrious 
properties by being kept in leaden pans for the use of the dairy. 
Mr. Parkes, author of a work on chemistry, expostulated with 
some persons in Lancashire who were in this habit; but, go- 
verned by selfish motives, they replied " that leaden milk-pans 
threw up the cream much better than vessels of any other ma- 
terial." 

Dr. Darwin relates the case of a farmer's daughter who, being 
fond of cream, was in the habit of taking it from the edge of the 
milk kept in leaden vessels and licking it from her fingers. She 
was attacked with severe lead colic, afterward with paralysis of 
the hands, and died of general exhaustion. 

That lead can act on milk and impart its peculiar properties 
to it there can be no doubt ; hence the old practice of expe- 
rienced mothers, many years ago, of giving milk, in which shot 
had been kept for some days, as a cure for looseness of the bow- 
els. It has been supposed that a small portion of acetate of 
lead was thus formed, and that this medicine was the curative 
agent. 

Next in order we notice the poisonous influence of the oxides 
of lead. These result from the union of metallic lead with 
oxygen, and this is effected by a high temperature and exposure 
to the air. Litharge and red lead are familiar to most general 
readers as oxides of lead. These prove poisonous accidentally, 
as in the common lead plaster employed for medical purposes ; 
in various processes of cookery, in which earthen vessels, glazed 
with the oxides of lead, are employed ; and sometimes by design, 
the oxide being intentionally added to some article of food to 
destroy life, or to some kind of beverage to improve its taste. 
To these we may subjoin with propriety the fact that oxides, as 
well as the carbonate of lead, are largely employed by painters, 
and induce in them the true eolica pictonum, or painter s colic. 

A man took three hundred grains of carbonate of lead in mis- 
take for chalk, as a remedy for heartburn. He was soon seized 
with burning at the pit of the stomach and obstinate vomiting. 
M. Schubert saw him in twenty-four hours after the mistake 
happened, and found him in great agony ; the face swollen, 
tongue dry, great thirst, belly tumid, and its pain relieved by 
firm pressure. Sulphate of magnesia, freely given and followed 
by opium, cured him. (See Edinburgh Medical and Surgical 
Journal, 1846.) 

There can be no doubt that a great deal depends, in respect 
of the poisonous operation of lead, on peculiarity of constitution ; 
as some painters, plumbers, and printers work regularly for years 



670 POISONED PRESERVES. 

without realizing any serious inconvenience. The lead plaster 
has been long known as a good application to ulcerated surfaces, 
and has been employed a thousand times without damage to the 
patient. But sometimes it is not so. The Med. Gazette of 
Paris, for 1838, gives a case of lead colic induced by this very 
agency. A man aged forty-one had an ulcer on the left leg, 
extending almost from the ankle to the knee. After trying 
many expedients, the lead plaster was applied in strips, with ob- 
vious advantage. During this treatment, a violent attack of colic 
supervened, having all the symptoms of colic from lead. The 
plaster was discontinued, and the disease did not appear again. 
Five months after this, the patient, of his own accord, tried the 
lead plaster again, and with the same pernicious result. His 
physician calculated that, in eleven weeks, the man had used 
forty-four square feet of the plaster, each foot of which contained 
one hundred and fourteen grains of oxide of lead. It followed 
that, in all, ten ounces three and a half drachms of the oxide 
had been in contact with the denuded surface. Every one knows 
that the workmen in lead factories, where oxide of lead is con- 
stantly blended with the air, are subject to colic; but in those 
cases the poison enters the system very much by the mouth, 
although the surface, often wet with perspiration, is equally 
exposed. 

The glazing of earthen vessels is composed partly of oxide of 
lead; and hence it results that many articles of food are ex- 
posed to a poisonous influence, for nothing is more common in 
domestic economy than earthen-ware. Vinegar corrodes these 
vessels readily, and thence we have certainly an oxide, and, 
often an acetate of lead, which finds its way into the entire 
contents of the vessel. It has often been a matter of astonish- 
ment that a pie of any sort, baked in a tin or earthen vessel 
and not eaten until the next day, should be a source of disquiet 
to a whole family. In hot weather, all such matters run quickly 
into the acetous fermentation, and the lead in the solder or 
glazing, with the arsenic in the tin, give a clue by which the 
mystery may be unraveled. In this case, however, it should 
be remembered that the animal and vegetable matters may un- 
dergo some unknowji change that may give them a deleterious 
quality; and although the protecting power of tin over lead, 
by reason of galvanic agency, may be argued against the exist- 
ence of any lead poison in such a piece of cookery in a soldered 
tin pan, yet the fact of poisoning from this source is beyond 
doubt. 

Some persons make a kind of preserve, that has just sugar 
enough in it to insure the acetous fermentation and the forma- 
tion of vinegar, and this in glazed earthen vessels. The con- 






POISONED BUTTER AND CHEESE. 671 

sequence is the production of acetate of lead, or certainly the 
oxide, and the preserved fruit is 'poisoned. Hundreds of per- 
sons have been seriously diseased from this cause. 

It is on the same principle, precisely, that apple-butter and 
pear-butter, and similar preparations, put away for safe keeping 
in earthen jars coated with lead glaze, are so frequently dele- 
terious. Kept in well-made stone jars, no inconvenience follows. 
This kind of vessel should always be preferred for keeping 
pickles in vinegar. 

It will rarely happen, we suppose, in a land of plenty, that 
butter will be a subject of adulteration with lead. We are told, 
however, that Gaubius detected white lead in butter in Flanders 
at a time when there was a dreadful mortality among cattle, 
and this article, as a consequence, was very scarce. Much more 
frequently is cheese poisoned with lead, a fact sufficiently well 
known, and therefore not calling for special notice at this 
time. I will say, however, that lead is not always the cause of 
poisonous effects from the use of cheese. Some years ago, in 
Frankford, Pennsylvania, many persons were sickened by a 
cheese the appearance and taste of which were of the first 
order. All who ate of it suffered. A part of the cheese was 
sent to me for examination, and two gentlemen in Philadelphia 
performed a similar service. We sought for lead and other 
poisonous agents, but nothing could be detected by the most 
delicate tests. The opinions entertained were, that the milk 
was probably taken from a cow laboring under milk-sickness; 
that the source of the mischief was some unknown vegetable; 
or that some spontaneous change had passed upon the cream 
which was not tangible by any known means of investigation. 

The Bulletin of Med. Science for Sept. 1843, furnishes two 
interesting cases of poisoning by the use of Maccabau snuff, to 
which a preparation of lead had been added. We do not know 
that the world would lose much if every form of tobacco were 
served in the same way. 

Sugar may be poisoned, either accidentally or by design, with 
lead in the form of oxide or salt of lead. A very interesting 
account is given by Dr. Jackson, in the Medical Magazine for 
June, 1835, of the poisoning of many persons in this way, in 
the town of Calais, in the State of Maine. Upward of one 
hundred persons were affected with all the symptoms of colica 
pictonum; three died, and others suffered more or less from 
paralysis of the extremities. That the sugar was the source of 
the evil was manifest from the consideration that several per- 
sons who dispensed entirely with sugar wholly escaped, while 
those suffered most who, from peculiar fondness for the article, 
consumed it most liberally. 



672 POISONED WINES. 

Chemical examinations were made by several individuals, and 
the presence of lead fully established. How it got into the 
sugar could not be ascertained. The conjecture was, that the 
juice of the cane must have been evaporated in leaden reservoirs, 
where a salt of lead resulted from the oxidation of the metal, 
and the union of the oxide with a vegetable acid present in the 
cane-juice. The means employed to detect the lead in this in- 
stance will be noticed hereafter. 

A case somewhat similar to that reported by Dr. Jackson is 
contained in the Transactions of the Medical Society of London, 
vol. i. "Every member of the family was seized with lead 
colic, and two of the number died. What was remarkable was 
the fact that a good deal of sugar, taken from the same barrel, 
had been sent to some friends, who were not at all injured by 
it. The symptoms of the sick were so obviously those of lead 
colic that not a doubt could be cherished. Every vessel and 
article about the house was searched in vain for the cause of 
all this mischief. At last it was discovered that the barrel con- 
taining the sugar had formerly been full of dry white lead, and 
that the present to the friends came from the centre, while that 
which had poisoned was taken from the outer portion, in contact 
with the white lead." This history is important, as it may serve 
to aid in ferreting out the true cause of poisoning in cases 
which, at first sight, may seem to be involved in great mystery. 

The July No. for 1842 of the American Journal of Medical 
Sciences, has an article from a foreign journal on poisoning with 
flour containing lead. Six members of a family were seized 
suddenly with obstinate constipation, vomiting, colic, &c, fol- 
lowed by spasms and pains of the hands and feet, emaciation, 
paleness, and anxiety. One of the number had dilated pupils, 
paralytic rigidity of the limbs, retraction of the abdomen, livid 
complexion, and great emaciation. The source of the poison 
was a box-full of shot in the cupboard where the flour was kept. 
The box was cracked, and it was believed that the flour acted 
on some of the shot that escaped by the cracks so as to be poi- 
soned by it in turn. The flour gave traces of the presence of 
lead. The patients recovered under the use of calomel, opium, 
and other medicines. 

One of the most wicked uses of the oxide of lead is its addi- 
tion to sour wines to make them of a better taste. This is 
done sometimes merely from selfish considerations, under the 
impression that the lead employed is too small in quantity to 
do harm. But it is also added with a full understanding of its 
pernicious effects, and the practice is highly reprehensible. 
The liquor in its best condition is, one might suppose, sufficiently 
hurtful to the morals and manners and health of the commit- 



POISONED WINES. 673 

nity ; but the cupidity of an avaricious man is not gratified with 
the sale of what he calls "sound wines," but he must turn to 
account those that are actually spoiled, himself being the judge, 
and in order to save them he adds a more noxious poison. 

It is true that the relative quantity of lead in a cask of wine 
may be small; but every one knows that the long-continued use 
of poison in small portions will often destroy life in the end. 
Hence the wisdom of a remark made by Dr. Gregory on intoxi- 
cating drinks, viz., " That the daily use of them, even in moderate 
quantities, was often much more hurtful to the system than an 
occasional drunken frolic." Accum has, therefore, said most 
truly, " That wine adulterated with the smallest quantity of lead 
becomes a slow poison." 

But not satisfied with litharge, as a means of arresting the 
acescent state of wines, some sophisticators add the acetate of 
lead. In the Vintner s Guide, page 67, the author directs a 
lump of sugar of lead, as big as a walnut, to be added to forty- 
two gallons of muddy and sour wine to cure it. 

Wine may be poisoned by the addition of a few shot, as will 
be seen presently. It is a very common device to put shot into 
wine bottles that have bi-tartrate of potash adherent to their 
sides, and, by frequent shaking, to detach the latter. In the 
Philosophical Magazine (London) for 1819, we find the follow- 
ing statement: — "A gentleman who had always enjoyed ap- 
parent good health, and who was in the habit of drinking half 
a bottle of Madeira after dinner, was taken ill (three hours after 
thus enjoying himself) with a severe pain in the stomach, at- 
tended with violent colic, which gradually yielded to appropriate 
treatment. On the day following, he drank the remaining half 
of his bottle of wine, and in two hours was attacked with most 
violent pains, headache, shivering, and general distress. The 
apothecary who was called to prescribe for the case, suspected 
the wine as the cause of these symptoms. The bottle was pro- 
duced by a servant, and, as it slipped out of his hand, a row of 
shot was observed wedged forcibly into the angular, bent up cir- 
cumference of it. On detaching the shot for inspection they 
crumbled into dust. The wine had gradually produced this 
change, and suffered itself in consequence ; as lead and arsenic, 
entering the composition of the shot, were both present in the 
wine." 

It would be well, in all countries where wine is consumed as 
largely and as ruinously as in America, if the decree of the 
Duke of Wurtemberg, made in 1690, could be enforced. He 
made it a capital offence, punishable with death, to add litharge 
to wine. 

Six individuals, after drinking cider for a few days, were 



674 LEAD POISON. 

seized with the usual symptoms of lead poisoning, viz., violent 
colic, obstinate constipation, pains in the limbs, trembling, &c. 
They got well under the usual treatment. On examination, it 
was found that the cider had been for two days in a reservoir 
lined with lead. The salt of lead thus formed was the malate, 
although that has been held to be insoluble. (See Edinburgh 
Medical and Surgical Journal, October, 1842.) 

A Mississippi paper of October, 1842, has the case of a family 
poisoned by eating peaches that were dried on a roof painted 
with white lead. Two of, the family died. It is probable the 
acid matter of the peach acted on the carbonate of lead and 
formed a more soluble salt. 

Not a little mischief has grown out of a well-known property 
of sugar of lead, that leads to its employment in the laboratory 
of the chemist. I mean its power to obliterate or throw down 
coloring matters. On this principle syrups are sometimes clari- 
fied with sugar of lead, and various chemical preparations are 
treated in like manner. Now, although the addition of this salt 
in exactly the right proportion would insure the precipitation of 
all its oxide of lead along with the coloring matter, and so pre- 
vent injury, yet that is an affair too often left to the carelessness 
of hirelings to make the practice at all safe. Hence syrups and 
the finer chemicals are sometimes adulterated with the lead 
poison, and may, of course, prove deleterious from that cause 
alone. 

The poisoning of painters, plumbers, and other workmen much 
employed in the use of lead or its preparations, has been ad- 
verted to. The effects are sometimes so suddenly produced, and 
the fatal issue occurs so unexpectedly, as to make it necessary to 
determine satisfactorily the cause. It is important, therefore, 
to be aware of the power of habit in these matters, and to be 
acquainted with facts that are not very common, but which may 
be repeated. Thus the poisonous action of the lead has been 
detected, satisfactorily, in a partial palsy induced by sleeping for 
two or three nights in a room newly painted with what is called 
a " dead white." The detention of a spectator in a lead factory, 
by mere curiosity, for an hour or two, has resulted in the usual 
symptoms of an attack of lead colic. The laborers in the esta- 
blishment, spending nearly all their time in the fumes of the 
metal in various stages of chemical action, escape unhurt for 
years, simply by living chiefly on fat broths, fat meats, the use 
of oleaginous fluids, and the like. 

It is stated in Mackintosh's Practice of Medicine that bathing 
the feet in a strong solution of sugar of lead, to correct a fetid 
perspiration, induced the usual symptoms of lead poisoning. 

It is not within our power to say how much of any given pre- 



LEAD POISON. 675 

paration of lead may be swallowed and fail to exert a decidedly- 
poisonous action. The reasons for this assertion are already 
known in reference to other poisons. The case of the Irishman 
with a sore leg who swallowed nearly an ounce of sugar of lead 
by mistake, is fresh in our memories. But we find in the Lon- 
don Medical and Physical Journal for 1803 a most extraordi- 
nary case, reported by Dr. A. Hunter. It is in substance as 
follows : — An apprentice lad living near to some calico printers, 
who make large use of sugar of lead, procured a lump as big as 
his fist, weighing not less than a pound, intending to mix some 
of it with a poultice which had been ordered for an inflamed ulcer 
on his leg. The lump was carelessly deposited on the kitchen 
table, and the mistress of the house, old and near-sighted, coming 
in with some cabbages picked for dinner, laid them on the sugar 
of lead and cut the whole into scraps without noticing the salt. 
The mess, together with some potatoes, entered a pot of water, 
and the process of ebullition quickly digested the whole. The 
master and mistress, a daughter and her husband, and two ap- 
prentices, consumed the meal. 

The dinner having been disposed of, the lad set about the pre- 
paration of his poultice, but, lo ! the sugar of lead was missing. 
It was remarked that the food had tasted somewhat strangely, 
and the discovery was soon made that their stomachs had been 
the receptacle of the lost article, and of course the family exhi- 
bited marked signs of alarm. Dr. Hunter soon arrived, and gave 
an emetic to all the persons who had eaten the meal save one, 
who, feeling no inconvenience, refused to take the medicine. 
Those who took the emetic were gently vomited, and there the 
matter ended. 

In this case about sixteen ounces of sugar of lead were allotted 
to six persons, as they swallowed the entire meal of cabbage and 
potatoes. But was the sugar of lead there, or did the coloring 
matters, or anything else in the vegetable substance, entirely de- 
compose the salt, throwing down an insoluble oxide, which might 
have been emptied out of the pot unnoticed by an old half-blind 
woman ? This may have been the r-esult, although we only con- 
jecture about it at this remote period. If the salt did not expe- 
rience this change, and the whole was actually held in solution, 
the case presents the largest portion of sugar of lead swallowed 
without injury that history has recorded.* 

* A young girl of good constitution, in a moment of despair took an ounce of 
sugar of lead in solution. Almost immediately she was seized with collapse and 
syncope, and afterward with vomiting and convulsions. Sugared water, sul- 
phate of magnesia, and sulphate of soda were given, but she died in twenty-five 
hours. She voided a large quantity of urine, which, on careful examination, 
was found to contain a sensible quantity of lead. — British and Foreign Medical 
Review, July, 1841, page 249. 



676 TESTS FOR LEAD. 

The late Professor Barton was in the habit of teaching that 
excessive doses of sugar of lead sometimes purged profusely, and 
in that way protected the system from its poisonous quality ; but 
in the case just quoted we find nothing of that sort. 

The usual action of large doses of sugar of lead is evidence 
of its irritant properties, and hence it is classed with irritant 
poisons. 

But if it be introduced gradually into the system, it brings on, 
as we have seen, that painful and often fatal form of disease 
called lead colic; and when this does not terminate in death, it is 
frequently followed by partial or more general palsy, and these 
by apoplexy. The chronic operation would seem to be evidence 
of narcotic poisoning, while the blue line running across the lower 
gums strongly indicates the deep fixidity of the poison, for the 
significant token is seen long after the poisonous manifestations 
began. 

When acetate of lead, or the carbonate of lead, applied to an 
abraded surface, brings on colic pains, as often happens in young 
children, they do so without inducing any obvious local irrita- 
tion, but appear to impress the bowels through the medium of the 
nerves. This use of lead preparations in children is, therefore, 
not quite as safe as some may imagine. I have known the mere 
dusting behind the ears with dry white lead, in order to relieve a 
discharge from the part, to be followed in a short time with severe 
colic. 

It is often said that sulphate of lead is perfectly insoluble, 
and therefore cannot be poisonous, but such is not the fact. It 
is soluble in acetate of ammonia, and this salt is contained in the 
perspiration. Thus the sulphate, when substituted for carbonate 
of lead in some works at Paris, proved fatal to the foreman, who 
died of colic. M. Elandin found that it poisoned a dog when 
rubbed into the skin as an ointment. — Headland' 's Action of 
Medicines, page 93. 

In addition to our casual notices of the mode of detecting the 
presence of lead, it is proper to devote a little further attention 
to the subject. 

The old-fashioned wine test answers very well for showing the 
presence of lead in wines. As it is easily prepared, we quote, 
from Accum, the usual recipe. Mix equal parts of finely-pow- 
dered sulphur and slaked quicklime, and expose the whole to a 
red heat in a common sand crucible for twenty minutes. Thus 
we get sulphuret of lime, to thirty-six grains of which add 
twenty-six grains of bi-tartrate of potash, (cream tartar.) Put 
the mixture in an ounce bottle, and then fill with water that has 
been boiled and allowed to cool. Shake well repeatedly, and let 
the dregs settle, after which pour the clear liquid into another 



TREATMENT OF LEAD POISONING. 677 

vial, into which about twenty drops of muriatic acid have been 
previously dropped. It is then ready for use, care being taken 
to keep the bottle well corked. If some of this liquid be added 
to wine containing either lead or copper, a dark-brown or black 
will be struck. If water be saturated with sulphureted hydrogen 
gas and acidulated with muriatic acid, it is a better test, and 
should be preferred. It gives a black precipitate, which is sul- 
phuret of lead, and is an extremely delicate test. 

To be assured that this is truly sulphuret of lead, and that 
lead was certainly present, collect the precipitate on a filter and 
dry it. Then place it in a small cavity formed in a piece of 
charcoal, and pass the flame of a blow-pipe directly on it. The 
compound is speedily decomposed, its sulphur flies off, and the 
metal appears. If this be detached and again heated by the 
blow-pipe, traces of the yellow and red oxide of lead will be 
seen. 

Sulphuric acid and the sulphate of soda form a white precipi- 
tate with lead that is insoluble in nitric acid. Thompson says 
the sulphate will give a white precipitate in water containing one 
hundred-thousandth of its weight in lead. 

The neutral chromate of potash gives a beautiful yellow pre- 
cipitate when added to a fluid containing lead in solution. This 
is chromate of lead. 

The hydriodate of potash, added to a lead solution, gives a yel- 
low precipitate of hydriodate of lead. 

When the lead poison is mixed with solid matters, the plan 
pursued by Dr. Jackson and others is proper. Thus the poisoned 
sugar, formerly spoken of, was burnt to a cinder in a platina cru- 
cible. The ashes were digested in nitric acid, evaporated to dry- 
ness, and the dry mass dissolved in water. To the filtered solu- 
tion, placed in a flask, sulphureted hydrogen gas was added, and 
a copious black precipitate of sulphuret of lead was the result. 
Every five hundred grains of sugar were thus found to contain 
two-thirds of a grain of oxide of lead. 

In addition to the symptoms already detailed as resulting from 
the poisonous action of lead, we name an astringent, metallic, 
and sometimes sweetish taste in the mouth ; pain in the stomach, 
and, after vomiting, obstinate constipation ; contraction of the 
abdominal muscles ; these are succeeded by a pallid countenance, 
tremors, occasionally delirium. In the chronic form paralysis is 
developed. 

The morbid appearances rarely amount to more than a stric- 
ture about the colon, or a general contraction of that intestine. 
But there are seldom any signs of inflammation. 

The treatment requires the ejection, if possible, of all the poi- 
sonous matter, either by the stomach-pump or by means of an 



678 TREATMENT OF LEAD POISONING. 

active emetic, as the sulphate of zinc. Sulphate of magnesia 
should be administered copiously to form an insoluble sulphate 
of lead, which is harmless, and also to act as a cathartic for the 
dislodgment of foreign matters. If this fail to purge, let castor 
oil be given in repeated doses, accompanied by purgative clysters. 
The warm bath is an important remedy to soothe the system and 
to relax spasm, and so favor the due evacuation of the bowels. 
The sulphuric acid lemonade spoken of in the article Acid sul- 
jihuric, should certainly be tried. The testimony in its favor is 
strong and the practice rational. The free use of mucilaginous 
drinks is also important ; and if the irritation of the stomach be 
considerable after free evacuations, denude the surface on the 
epigastrium to the size of a dollar, and apply a grain of the sul- 
phate of morphia. Sometimes it is necessary to reduce morbid 
action by venesection and leeches. 

When paralysis of the extremities follows colica pictonum, 
the best treatment consists in small doses of the acetate of 
strychnia, and occasionally galvanic shocks. One-tenth of a 
grain of the strychnia is a sufficient dose to begin with, very 
gradually augmented until tetanic spasms are visible. 

The agency of sulphuric acid in decomposing sugar of lead, 
and so destroying its poisonous character, will be seen in the fol- 
lowing case, extracted from the Journal de Chimie Medicale for 
June, 1839. 

A girl about twenty-one years of age, quite feeble and delicate, 
was brought to the hospital by two police officers, on the 20th of 
May. She had swallowed the poison about a half an hour be- 
fore. Her distress was extreme, face pale, a black circle round 
the eyes, the lips livid and dry, skin hot and moist, pulse feeble, 
threadlike, and she had hiccough. 

Having ascertained what sort of poison had been swallowed, 
an injection was thrown into the stomach by means of the sto- 
mach-pump, containing about a pint of the compound infusion of 
roses. It was expected that the sulphuric acid of this infusion 
would decompose the acetate of lead and form an insoluble sul- 
phate. Shortly after, the contents of the stomach were removed, 
the patient put to bed, hot fomentations applied to the thighs 
and feet, and several doses of camphor and ether administered. 
In an hour after this an ounce of castor oil was given which 
operated copiously. 

Next morning the patient had high fever, and severe pains at 
the pit of the stomach. To relieve these the saline mixture was 
ordered, leeches and a blister applied to the cardiac region. These 
remedies gave great relief, and she soon recovered. 

The occasion of this attempt at suicide was disappointment in 
a love affair. The girl bought twopenny worth of sugar of 



SENEKA SNAKEROOT. 679 

lead at a druggist's, for the purpose, as she said, of killing mice. 
On going home she swallowed the whole, being probably an 
ounce. 

It may be proper to say that this notice of the poisonous 
action of lead was first published by the author of this work in 
the Western Medical and Surgical Recorder for 1842. 

Polygala Senega. Seneka Snakeroot — sometimes called 
Rattlesnakeroot. — This plant is perennial, with twisted roots, 
having branches which shoot out nearly as thick as a finger, 
covered with an ash-colored or gray bark. It is a native of North 
America, growing abundantly in Pennsylvania, Ohio, Kentucky, 
Tennessee, &c. &c. It is met with on hillsides and in dry wood- 
lands, flowering in June, July, and August, in different locations. 
The root has not much odor; and when chewed it leaves a 
rather bitterish, warm, pungent taste, exciting a peculiar ting- 
ling sensation in the fauces, which remains after the root is spit 
out. 

The watery infusion has a pale-yellow color, a feeble smell, 
and tastes very much as the root. The addition of sulphate of 
iron effects no alteration in its color, and hence there is no in- 
compatibility. Gehlen detected a peculiar proximate principle, 
to which he gave the name of senegin. Peschier obtained an- 
other, and to it he assigned the term polygaline. But they are 
identical. 

Seneka snakeroot is stimulant, sudorific, expectorant, and 
emetic ; to which we may add its alleged quality of emmenagogue. 
In full doses the emetic effect is sometimes followed by a cathartic 
action, while in smaller doses the nauseant operation makes it an 
expectorant. 

Being a stimulant, it is not proper in the first stage of inflam- 
matory disease ; but when that has passed, or been reduced by 
any suitable means, the gently-stimulant action results in a favor- 
able diaphoresis. 

We are indebted to Dr. Tennent for some information that 
sheds light on the connection between the skin and the organs of 
the chest under the action of the seneka snakeroot. He tells us 
that the Indians employ the root extensively to cure bites of the 
rattlesnake, (hence one of its names,) and that when it acts favor- 
ably in regard to the poison of the reptile, it induces obvious 
symptoms of pleuritic or pneumonic inflammation. Dr. T. thence 
inferred that the medicine might be useful in pneumonia. He 
made trial of it, and with benefit. We presume he premised the 
use of the lancet, as that would seem to be a necessary prelimi- 
nary. After depletion, the seneka may be useful by promoting 
expectoration and relieving tightness of the chest. 

In severe coughs and colds, the decoction of the seneka snake- 



680 WATER PEPPER. 

root with liquorice root and rock-candy will often afford relief. 
An ounce of each is added to a pint of boiling water, to digest 
for two hours. The dose is a wineglassful every hour or two. It 
proves expectorant and diaphoretic. 

Dr. Joseph Hartshorne, of Philadelphia, was the first person, 
so far as I know, who placed much confidence in the emmena- 
gogue powers of this medicine. He regarded it as very effectual 
for the relief of amenorrhoea, and I have found it a very good 
remedy in the same form of catamenial derangement. The 
saturated decoction should be drunk to the extent of a pint in 
twenty-four hours, commencing a few clays prior to the expected 
discharge, and repeating daily. It is advisable in most cases to 
precede the use of the decoction with two or three doses of calo- 
mel and jalap, or rhubarb. I have been very much pleased with 
this treatment of young girls, who feared the approach of pul- 
monary consumption, because of suppression of the discharge, 
and some chest disturbance at the same time. 

The more common decoction (an ounce to a quart of boiling 
water) is an excellent medicine for the relief of hoarseness, and 
loss of voice, or aphonia. It should be used as a gargle very 
frequently. 

In dropsy, rheumatism, and asthma, this root has been a use- 
ful medicine. Dr. Bree speaks well of the decoction in the 
asthma of old persons, while he found it injurious to young 
patients, because too stimulating. 

It was once held in estimation in the treatment of croup, es- 
pecially when combined with calomel. The late Dr. Samuel P. 
Griffith, of this city, was very partial to this treatment. The 
seneka alone is too feeble, and demands the powerful aid of the 
mercurial in the inflammatory or membranous form of that fatal 
disease. 

The dose of the powdered root is from ten to thirty grains ; 
of the common decoction, from one to three ounces three or four 
times a day. 

Polygonum Htdropiper. Water Pepper. Arsesmart. — 
This American plant is well known to the common people, espe- 
cially in the West, where it is prized for its agency on the ute- 
rine system. I have read a good thesis on its remedial powers, 
furnished by a candidate in Ohio. The late Professor Eberle 
highly valued it in amenorrhoea. Dr. Ogier published a paper 
in the Southern Journal of Medicine and Pharmacy, laud- 
ing it in very strong terms. He says he knows of no medi- 
cine that has so decided an action on the uterus. He made a 
tincture of the stem, leaf, and flower, which may be called a 
saturated tincture. The dose was a teaspoonful three times a 



MALE FERN — CAUSTIC POTASH. 681 

day in sweetened water. It is regarded as an emmenagogue and 
diuretic. 

Polypodium Filix Mas. Male Fern. — The powdered root 
of this plant has long been celebrated for its vermifuge powers, 
and particularly for its efficacy against tcenia, or tapeworm. It 
entered the famous anthelmintic specific of Madame Nouffer. 
Two drachms of the powder make an adult dose, which may be 
repeated, and followed by a brisk cathartic' 

Potash. Oxide of Potassium. Formerly called vegetable 
alkali, fixed alkali. — These alkaline terms grew out of the fact 
that the substance was readily obtained from vegetable matter, 
and that it was not a volatile, but a fixed or permanent product. 
The decomposition of potash by the galvanic battery, and the 
metallic base thus procured, fixed its real nature ; and we now 
call it an oxide, although it has the peculiar qualities assigned to 
an alkali. 

Pure potash is exceedingly caustic, and is, in fact, the best 
kind of caustic potash, or common caustic, in contradistinction 
from lunar caustic. It is employed as an eschar otic by surgeons, 
who sometimes style it the 'potential cautery. It is very deli- 
quescent, and must therefore be kept in very close bottles. The 
purest kind is formed by the combustion of potassium, which 
yields the oxide. It is obtained usually by the following process : 
— Take of the aqueous solution of potash, three pints ; fresh 
quicklime, a pound. Boil the solution of potash to a pint, and 
add the lime, (being first slaked,) and mix them thoroughly. The 
pure lime takes the carbonie acid from the potash, and carbonate 
of lime is formed, as well as pure potash. In order to detach 
the pure alkali, . the whole must be digested in alcohol, which 
takes up the potash and leaves the carbonate of lime. The alco- 
holic solution being poured off and distilled, yields the pure pot- 
ash, which is called pure potash by alcohol. If the solution of 
pure potash be evaporated to dryness, and the mass be fused 
with heat gradually augmented, till it flows like oil, and is then 
poured into moulds, it forms the well-known lapis infernalis, or 
common caustic of the shops. As it becomes cold in the moulds 
it contracts and is readily separated. 

A quantity of this caustic, suspected of being partially car- 
bonated by exposure, can be purified by admixture with quick- 
lime, just as it is needed by the surgeon. The whole being in 
form of paste, is thus made to possess very decided escharotic 
power. Applied to the surface, and prevented from spreading, 
it soon forms an eschar, and finally establishes an issue or drain. 
This is done in cases of diseased spine, the caustic being applied 
on both sides of the spinal column. To insure the confinement 
of the paste, a circular hole is cut in a piece of adhesive plaster, 

44 






682 POISONING BY POTASH. 

spread on thick sheepskin, of the size of a fifty-cent piece. The 
plaster is applied warm to the spot and the circular space filled 
with the paste, and then another piece of the adhesive plaster is 
laid over the whole. After the application has been made some 
three or four hours, it is to be taken off, and a soft bread and 
milk poultice applied to detach the eschar and open the drain. 
Dr, II. Bennet has succeeded in preparing a solid caustic potash 
in the stick form that does not deliquesce, and can be applied as 
conveniently as lunar caustic. He has employed it in uterine 
diseases, and thinks it will prove equally valuable in general sur- 
gery. The details are not given. — Lond. Lancet, June, 1850. 

Dr. Jones, surgeon to the South London Dispensary, treated 
between sixty and seventy cases of external hemorrhoids very 
successfully, in the year 1849, by the application of caustic pot- 
ash. This article was applied every four days, and by three 
applications the tumors were completely removed. The patients 
realized considerable burning, which sometimes continued for an 
hour. (See Braithwaite s Retrospect, part xx.) 

The ordinary potash of commerce is obtained from the ashes 
formed in the combustion of ordinary firewood, a ley being first 
made by the action of water on the ashes. This ley is the im- 
pure potash, which is separated by boiling, and then allowing 
the mixture to stand undisturbed. It is called potash to distin- 
guish it from the fact of the process being conducted in large 
pots. It is an impure article, compared with pearhsh, which is 
the same thing substantially, the chief difference consisting in 
its greater purity and pearly whiteness. 

The ley spoken of and the impure potash, by combination with 
fatty matters, give rise to the various kinds of soap so largely 
employed in domestic economy. Both the ley and solution of 
potash are exceedingly poisonous when taken by accident into 
the stomach, and should be speedily dislodged or neutralized 
by oils or vegetable acids administered liberally. 

It will be seen that the poisonous action is very much like 
that of the mineral acids, although they are opposed in their 
chemical relations. The latter are more prompt in the work of 
disorganization, and hence they kill in a shorter time. The 
alkalies seldom destroy life before twelve hours have elapsed 
from the occurrence of the accident. 

The following cases are so important that I quote them at 
length: — On the 2d of November, 1818, I was called, says Mr. 
Dewar, in Edinb. Med. and Surg. Journal, vol. xxx., to visit a 
little boy who had drunk about three ounces of a strong solution 
of carbonate of potash, (equal to a very strong ley.) I saw him 
an hour after the accident. The tongue, gums, and fauces were 
shockingly destroyed; the cuticle appearing as if seared with a 






POISONING BY POTASH. 683 

hot iron, while the inside of the cheek, roof of the mouth, and 
velum were entirely inflamed. He complained much, and vomited 
incessantly. Every attempt to swallow gave him great pain. 
Nevertheless he was encouraged to drink vinegar and water, of 
which he swallowed a good deal; but it was instantly rejected. 
He took also occasionally a mouthful of linseed tea. So remedy 
was of the least service, and in twelve hours from the occurrence 
of the accident he was a corpse. 

The examination after death presented the appearances in the 
mouth already noticed. The mucous membrane of the pharynx 
and oesophagus was almost entirely destroyed. Blood was every- 
where extravasated between the muscular and pulpy mucous 
coats. The stomach was generally inflamed, but especially along 
the great curvature. In two place?, about the size of a shilling, 
the mucous membrane was destroyed, and the injured surface 
was covered with clotted blood. The stomach contained a small 
quantity of a bloody fluid. The peritoneal covering was not 
affected, nor were any of the other viscera injured. 

One or two remarks may be properly made on this case. And, 
in the first place, it is probable that no remedy was tried until 
an hour had elapsed after the accident, and sufficient time had 
then been allowed for the poison to do irremediable mischief. No- 
thing could have saved the patient. In the second place, the 
administration of diluted vinegar at a late period in the case, 
when the highest degree of gastric irritation prevailed, was 
entirely wrong. It could not then neutralize so as to undo what 
had been done; but.it could not fail to augment the existing 
irritation, and hence we are told that it was instantly rejected. 

Another case is given by Mr. Dewar, which illustrates a prin- 
ciple several times adverted to, viz., the power of circumstances 
to modify the action of poisons. A female, who had been suck- 
ing at the whisky bottle nearly all the day, drank by mistake a 
wineglassful of a strong solution of carbonate of potash. In a 
note, we learn that this woman had been a drunkard for nine 
years, that she was intoxicated for six weeks without inter- 
mission, drinking every day during that period a half-gallon of 
whisky, and sometimes a larger quantity. Here was a system 
under the influence of the poison of alcohol for so long a time 
as to prevent the ordinary operation of another poison. This, 
however, is just what we ought to expect. A case has been 
stated in this work, of a woman whose stomach so completely 
lost its susceptibility of impression from alcohol in every shape 
that she resorted to aqua-fortis, and partook of it with satisfac- 
tion, — that is, the satisfaction of a drunkard. 

In the case before us, enough of the alkaline carbonate was 
swallowed to have displayed its wonted symptoms under ordi- 



684 POISONING BY POTASH. 

nary circumstances. But here, the facts are otherwise. The 
poison was swallowed at five o'clock on Sunday evening, and at 
eleven of the next morning little pain was realized, the night 
having been passed without much uneasiness. Pressure on the 
epigastrium gave some uneasiness and excited a disposition to 
vomit. The mouth and fauces were now coated with a dirty 
brown slough, which rendered the whole surface insensible to the 
touch. Swallowing was difficult, and fluids taken in were quickly 
ejected. During a month, large portions of tough matter, adhe- 
rent like leather, were brought up by coughing, hawking, or 
vomiting. I have no doubt that the animal texture had been 
greatly disorganized by intemperance, and that the alkaline 
poison spent its force in augmenting that condition of the general 
system, instead of displaying its energy, as is most common, in 
a more local manner. The sufferings of the patient were pro- 
tracted to nearly six months, and were of such a nature as to im- 
press the mind most forcibly with the sentiment that the noxious 
influence of alcohol laid the foundation for all the peculiarities 
that marked the case. Dissection revealed such a condition of 
the gullet and stomach, such extensive strictures and ulceration, 
as to account for the starvation spoken of by the narrator, and 
which no doubt ultimately killed her. 

It usually happens, in temperate persons, that the accidental 
swallowing of potash in any form, so as not to kill promptly, 
proves fatal at last by the starvation caused by utter inability to 
swallow anything. We are informed by Mr. Charles Bell that 
he had a patient who lived twenty years after the accident, which 
in that case was from soap-lees, yet death was attributed to the 
permanent stricture, caused originally by the local action of the 
poison, and which finally effected absolute starvation. 

The following case is specially interesting, on account of the 
rapid recovery of the patient: — Mr. D., aged thirty-five, drank, 
instead of wine, a quantity of water of potash. Soon perceiving 
the error, he complained of severe pains in the epigastric region, 
and nausea, and, in the course of a quarter of an hour, of general 
coldness ; face pale, presenting the appearance of intense suffer- 
ing. A solution of tartaric acid was administered, (four drachms 
to the pint of water,) and given at short intervals. Sinapisms 
were applied to the feet, and emollient fomentations to the abdo- 
men, with frequent enemas. In a short time the symptoms- 
abated, and he began to grow warm ; a slight perspiration con- 
tinued for two hours, followed by a black stool. Two days after, 
the tongue and back part of the mouth threw off a very thick 
and tough membrane. The patient took small quantities of 
broth, and shortly recovered his health. — Gazette Medicale de 
Paris, November, 1836. 



CARBONATE OF POTASH. 685 

Soap has been employed very successfully in the treatment of 
burns and scalds. The simplicity of the remedy, and its presence 
everywhere as a domestic article, commend it to popular favor. 
Dr. Williamson, physician to the Leith Dispensary, employs it in 
the following manner : — He makes a thick lather in a large shav- 
ing-box, and applies it to all the burnt surfaces, repeating as soon 
as the first coat begins to dry or the pain returns. The latter 
should be repeated through the day, when the patient complains 
of pain. The benefit to the patient is immediate, and the result 
highly satisfactory ; for in superficial burns vesication is pre- 
vented, if the soap be applied early. Even when burns are 
deep, the application is useful, the patient deriving great per- 
sonal comfort from it. (See Braithwaite, part iv.) Some per- 
sons have used common brown soap, by spreading it on old linen 
and covering the entire burnt surface. 

Liquor potassoe is a watery solution of pure potash, and was 
formerly much employed as an antacid and lithontriptic. In 
calculous affections, with preponderance of uric acid, this solu- 
tion was much esteemed, and is yet employed. It is made by 
detaching carbonic acid from a solution of carbonate of potash 
by means of quicklime. A pound of the carbonate, half a 
pound of lime, and a gallon of boiling water are to be mixed, 
and, after cooling, the solution is to be filtered through a cotton 
strainer. A pint of the liquor potassae so made should weigh 
sixteen ounces, and the solution should be quite clear and with- 
out tinge. The taste of this solution is quite acrid and highly 
alkaline. It destroys the texture of animal and vegetable mat- 
ters rapidly. The dose is from ten to fifty drops in sweetened 
water or bitter infusion. Dr. Mulock, of Dublin, gave this solu- 
tion, with almost immmediate success, in strangury. The dose 
was thirty drops, in a half- wineglass of water, every hour. (See 
New York Journal of Medicine and Surgery, Nov. 1844.) 

This and all other alkalies are used when there is excess of 
acid in the system, whatever that acid may be. Alkali should be 
present to neutralize it, for it is unnatural to have an excess of 
acid in the secretions, or any excess in the blood. Alkalies thus 
administered restore the blood to its proper state, in respect of 
acidity, and hence they are called by some restoratives. These 
remedies are not always excreted, but whether excreted or no 
they tend to render the secretions neutral and alkaline by in- 
creasing the quantity of basic matter in the system. — Headland's 
Action of Medicines, p. 143. 

Carbonate of Potash. Subcarbonate, kali preparata, sal 
absinthii, salt of tartar. — Strictly speaking, there are but two 
varieties of this salt, viz., the carbonate and bi-carbonate, em- 
ployed in medical practice. We have seen already that the 



686 EFFERVESCING MIXTURES. 

common pot and pearlashes are impure carbonates. A purer 
kind is made by decomposing cremor tartar by means of a strong 
beat. The salt should be kept in a well-stoppered bottle, because 
of its aptitude to absorb atmospheric moisture. The oleum tar- 
tari per deliquium has been accidentally formed by exposing a 
bottle of the carbonate of potash to the air for a long time. 
Carbonate of potash may, and does, sometimes, contain lime, 
which can be detected by adding a little oxalic acid to a watery 
solution. A white, dense precipitate of oxalate of lime is seen 
instantly. We determine the real alkaline strength of this arti- 
cle by the neutralizing power, or its ability to take up a certain 
quantity of acid. The larger the quantity of acid thus disposed 
of the greater is the alkaline strength of the solution of potash 
employed. 

The incompatibles of the carbonate are the acids and acidulous 
salts, borax, sal ammoniac, acetate of ammonia, Epsom salt, lime- 
water, nitrate of silver, calomel, corrosive sublimate, acetate of 
lead, tartar emetic, sulphates of zinc, copper, and iron. 

The carbonate has long been employed in practice. One of 
the oldest remedies for pertussis is the popular mixture of this 
salt, cochineal, and sugar; the cochineal being added simply as 
a coloring, and the sugar not exerting any very special agency, 
the benefit has been ascribed to the carbonate. A more general 
use of the salt has been in the preparation of saline and effer- 
vescing mixtures. A mere saline mixture is readily made by 
adding a teaspoonful of the carbonate to two or three ounces of 
water. This will not only neutralize acid matters in the sto- 
mach, but is very apt to excite a free perspiration, if repeated, 
in tablespoon doses every hour. It is, therefore, diaphoretic as 
well as antacid. 

The effervescing mixture is very extensively employed, and is 
almost indispensable. We can form it in a moment by mixing 
a solution of the carbonate and lemon-juice, or vinegar. This 
can be done out of the body, the mixture being swallowed in- 
stantly ; or, the alkaline solution having been taken first, the 
acid should follow without delay. On the meeting of the two, 
chemical action ensues, carbonic acid gas is copiously evolved, 
and effervescence thus established. 

The following mixture has been exhibited by Dr. Bayles, to 
arrest vomiting and irritability of stomach, with great success : — 

R.— Carb. pot. J}i; 

Aq. menth. pip. ^i; 

Tinct. catechu, ^i; 

Syrup simp, gij ; 

Tinct. opii, 9 SS - 
Mix. 



NITRATE OF POTASH. 687 

Dissolve eighteen grains of citric acid in an ounce of water, 
or have in readiness a tablespoonful of lemon-juice. Let the 
patient swallow the mixture of the carbonate of potash, and then 
the acid solution or lemon-juice. The effect is immediate, and 
often proves salutary. 

The carbonate is sometimes administered in doses of from ten 
to twenty grains, in dyspepsia dependent on acidity. Here it 
acts purely by its neutralizing power. 

Fifteen grains of citric acid, or four drachms of lemon-juice, 
will decompose twenty grains of the carbonate. The product is 
a true citrate of potash, and is equivalent in its remedial agency 
to the salt sold as citrate of potash. It is often a very useful 
article in febrile affections, and if taken in the effervescing state 
will generally allay irritability of stomach. 

In regard to the synonyms named above, it may be well to say 
a word or two. I have seen several bottles, side by side, on the 
shelf of an apothecary shop, labeled carbonate of potash, sub- 
carbonate of potash, sal absinthii, sal tartari, as though they 
were really different in any essential point. They do not differ, 
excepting in coloring or smell, and that is designed to keep up 
the notion of a difference. The sal absinthii, or salt of worm- 
wood, is carbonate of potash containing enough oil of wormwood 
to disguise it. 

Bi-carbonate of potash contains twice as much carbonic acid as 
the carbonate, and hence it is sometimes called sitper-carbonate. 
The additional carbonic acid very much alters the qualities of the 
salt, its appearance, &c. It is obtained in regular crystals, which 
do not deliquesce, and its taste is more agreeable than that of 
the carbonate. It is very soluble in cold water, but insoluble in 
alcohol. Hot water decomposes it, and expels carbonic acid. 
One hundred and one grains of crystallized bi-carbonate of potash 
are decomposed by seventy-five of crystallized tartaric acid, or 
by seventy-six of crystallized citric acid. The bi-carbonate is 
more costly than the carbonate, but far more pleasant for irrita- 
ble stomachs, whether in powder or in effervescence. The incom- 
patibles do not differ from those of the carbonate. 

Nitrate of potash, nitre, or saltpetre, is a very useful salt, 
and ranks among the remedial appliances denominated anti- 
phlogistic. It is composed of one equivalent of nitric acid and 
one of potash, and is called a neutral salt. It may be formed by 
the direct action of nitric acid on carbonate of potash. It has 
been found largely as a natural production, but has been exten- 
sively manufactured from heaps of compost, as in the times of 
the American Revolution. Lime was thrown into those heaps, 
and the nitric acid, formed by the union of nitrogen evolved from 
the decomposition going on with atmospherical oxygen, gave 



688 SALTPETRE POISONOUS. 

rise to the nitrate of lime. This being separated by the forma- 
tion of a ley, by addition of potash, gives birth to nitrate of 
potash, which is separated and procured by an easy process. 

Nitre is soluble in seven parts of water at 60°, and in its own 
weight at 212°. It is insoluble in alcohol. The aqueous solu- 
tion, fresh made and instantly employed, is decidedly refrigerant, 
for the solution in water causes a reduction in temperature. It is 
obvious, however, that if the solution be allowed to stand an hour 
of two before it is swallowed or applied to the surface, it will not 
be a refrigerant, because it has no longer a reduced temperature. 
The taste of the nitrate of potash is rather saline, and yet it is 
cooling, with some pungency. Its incompatibles are alum, Epsom 
salt, sulphuric acid, and sulphates of copper, zinc, and iron. 

Owing to some resemblance to Glauber's salt, in respect of the 
external aspect, nitrate of potash has been swallowed in mistake 
for the purging salt. A fellow-graduate was nearly destroyed 
by such a blunder, committed a few days prior to the commence- 
ment for conferring degrees. He should have known the differ- 
ence in taste, for that is sufficiently obvious to serve as a guide : 
the purging salt being much more alkaline and unpleasant than 
the nitre. The two salts are acted on very differently by red-hot 
coals. The nitre deflagrates and augments the combustion ; 
whereas the Glauber's salt tends to extinguish the fire by reason 
of its great quantity of the water of crystallization, and it never 
deflagrates. Heated sulphuric acid decomposes the saltpetre, 
but does not affect the Glauber's salt at all. The young doctor 
fortunately made this experimental error in his own person, and 
learned very thoroughly how to avoid a repetition in any who 
might be his patients. He was saved by active vomiting, and 
the subsequent use of emollient and mucilaginous drinks, with 
opiates, and external irritants to the epigastric region. He took 
a full ounce of the saltpetre. Twice as much has been taken in 
mistake, and the patient got well. (See Memoirs Lond. Med. 
Society, vol. iii.) 

The Philadelphia Medical Neivs gives the case of a man who 
took over two ounces, in mistake for Epsom salt. In five minutes 
he had severe burning pain in the stomach, and was inclined to 
vomit. A mustard emetic was given, and this followed by car- 
bonate of magnesia and opium. The patient was soon well. 

There can be no doubt that very great doses of this salt fail to 
poison, in some instances, because they are antagonized by ex- 
isting disease, just as tartar emetic is neutralized by acute 
pneumonia. 

Nitrate of potash is largely employed in fevers, and has been 
called a febrifuge. Given in five or ten-grain doses every hour 
or two, it not only reduces arterial action, but is also diuretic. 



USES OF SALTPETRE. 689 

The dose is best given in a wineglass of cold water. To increase 
the whole effect, the well-known formula of Rush is among the 
best that I have employed. 

R. — Nit. pot. ^i; 

Ant. tart. gr. i. 
Mix, and divide into twelve powders. 

Each dose, as above, contains five grains of nitre and a twelfth 
of a grain of tartar emetic. Besides reduction of febrile symp- 
toms, there is both a diuretic and diaphoretic result, if the pow- 
ders be repeated every hour or two hours until all are exhibited. 
To the above mixture enough calomel may be added to give a 
grain to each powder, when it is desirable to induce gentle ptyal- 
ism very speedily. 

I learned, while in Kentucky, that saltpetre was employed as 
a popular medicine in the treatment of calculous disease, such as 
the common people designated by the term gravel. There can 
be no doubt that the remedy operated very much by augmenting 
the urinary discharge, and thus conveying the calculous matter 
out of the system. An ounce of saltpetre is boiled for a few 
minutes in a quart of new milk, and a tablespoonful is taken 
every hour, the repetition being continued for days and weeks. 
It is quite easy to calculate that each dose contains nearly eight 
grains of the salt. 

The nitrate has been administered in very large doses in 
haemoptysis, evidently of what the writers call the active or acute 
form. M. Guadinan employed the salt as follows : — Fifteen 
scruples (300 grs.) were dissolved in one hundred and twenty 
scruples of gum-water, sweetened with fifteen of syrup. Two 
mixtures of this kind were consumed in twenty-four hours, mak- 
ing six hundred grains of saltpetre. It is said that this quantity 
never impaired the digestive apparatus in any perceptible degree. 
It succeeded in the most alarming hemorrhages, after general 
and local bleeding and astringents had been unavailing. (See 
Provincial Medical Journal, 1842.) It is stated in Villard's 
Clinical Repertory that half-ounce doses have been given, for the 
relief of hsemoptysis, with marked success and no bad results. 
These facts teach us that the objection raised to the use of pot- 
ash as an antidote for nitric acid, on the ground of forming a poi- 
sonous salt, is purely ideal. 

Dr. Carlyon, physician to the Cornwall Infirmary, speaks 
favorably of the nitrate of potash as a remedy for purpura 
hemorrhagica. He says it does best when given with an equal 
quantity of sugar in cold water, in doses of from ten to twenty 
grains, every two or three hours, or more frequently if the case 
be urgent. (See Braithwaite, part xix.) 



690 USES OP SALTPETRE. 

The same medicine has been exhibited in large doses, also, in 
acute rheumatism, and may be regarded as part of the eliminat- 
ing treatment advocated by Dr. Todd, and noticed elsewhere in 
this volume. (See Elimination.) Eight drachms have been 
given in twenty-four hours, or twenty grains per hour continu- 
ously. Copious perspiration and increased flow of urine were 
prominent results of this practice, and the reduction of the 
arterial force was a necessary consequence. The remedy is 
affirmed to be most successful when administered very early in 
the attack. The London Lancet for 1843 offers an explanation 
of the operation of these large doses of the nitrate ; but we sup- 
pose it to depend on a principle already named, viz., the antago- 
nism of poison and disease. It is on the same principle that im- 
mense doses have been safely given in inflammatory diseases of 
high morbid action, as reported in the Medic o-Qhirurg. Rev. for 
1844. This bold use of nitrate of potash can be traced back to 
the time of Dover, (original proprietor of Dover s powder.) He 
treated acute rheumatism in athletic persons with copious bleed- 
ing and six hundred grains of nitre daily. The salt was added 
to water-gruel, in the proportion of two drachms to a pint. (See 
Coxes Esculapian Register, July, 1844.) 

The largest doses of nitre ever given in regular practice have 
been referred to already. Villard's Clinical Repertory has 
informed us that half-ounce doses were given for relief of 
haemoptysis. In a foreign hospital, ascites was treated, recently, 
with the same remedy carried so far that almost an ounce and a 
half was the amount consumed in twenty-four hours. The effu- 
sion soon disappeared, and the appetite and strength were re- 
stored. No other medicine was administered. We gather the 
facts from the N. Amer. Med.-Chir. Rev. for May, 1857. 

Nitrate of potash has also been employed as a remedy for in- 
continence of urine, a result that does not seem to accord with the 
action of the medicine in acute rheumatism. Dr. Young reports, 
in the American Journal of Medical Sciences for 1843, decided 
success with ten-grain doses, every three or four hours, given in 
flaxseed tea. The remedy is to be continued for five or six 
weeks, and has succeeded in congenital cases as well as in others. 
Dr. Young thinks the medicine acts by increasing the irritant 
properties of the urine. 

Cigars, made of paper saturated with nitrate of potash, have 
been employed with some success by asthmatics. The cigars are 
smoked by the patient, or allowed to burn in the chamber. As 
a mere change of expedients, it may be well enough, and deserves 
a trial. 

We may very profitably add nitrate of potash to infusions of uva 
ursi or buchu ; the diuretic effect is very greatly increased. For 



CREMOR TARTAR. 691 

this end, two drachms may be added to a pint of infusion. We 
sometimes add it also to spiritus mindereri, to augment the anti- 
phlogistic powers of the mixture. 

The most novel therapeutic property assigned to nitre is given 
by a physician of Leipsic. He says that from a scruple to a 
drachm, given daily in any bland fluid, as gum-water, will pro- 
mote the catamenial flow, and he therefore calls it an emmena- 
gogue. We presume, if the statement be correct, that the doc- 
trine of elimination will serve for a solution, as the conveyance 
out of the system of irritant matter relieves the ovaries from 
undue excitement, and so enables them to do their appropriate 
work. 

M. Mangenot, in the Bulletin de Therap., recommends the 
application of nitrate of potash for the cure of ncevus. The 
moistened finger is dipped in the powder and the nsevus gently 
rubbed with it. A small bulla, as observed in herpes labialis, is 
formed, and the tumor shrinks away, so that one other applica- 
tion may suffice for its entire suspension. This was the result in 
four cases of nsevi in the face. In a fifth case, in which a nsevus, 
four centimetres in diameter, existed on the shoulder, the same 
treatment removed it in a month. 

Sal prunelle of the books is simply melted nitre poured into 
small moulds. The water of crystallization is expelled in the 
process, and hence the greater hardness of the salt. It has no 
special properties to make it valuable. 

Tartrate of potash. — The combination of tartaric acid gives 
rise to salts differing in medicinal properties, according to the rela- 
tive quantity of their acid. Hence we have the neutral or soluble 
tartar, and the comparatively insoluble cremor tartar, with the 
acid in twice the quantity that exists in the former. The one is 
tartrate, the other bi-tartrate of potash. As the tartrate is made 
of the bi-tartrate, we shall notice the latter first. 

Cremor tartar, or bi-tartrate of potash, (or supertartrate, as 
some call it,) exists in the crude tartar of commerce, in union 
with the coloring matter of wine and other impurities. This 
crude tartar is formed in the process of wine-making, and is de- 
posited on the inside of wine casks, because not soluble in the 
fluid as it becomes older and more decidedly alcoholic. Large 
quantities of this crude deposit are thus obtained, and by long 
ebullition with wood-ashes and the addition of albuminous mat- 
ter the pure cremor tartar is separated, as a white pulverulent 
mass, having a harsh, rough feel when pressed between the thumb 
and fingers. It requires one hundred and twenty-five parts of 
water for solution, at 60° Fahrenheit, and thirty parts at the 
boiling point, or 212°. The salt is decidedly acid to the taste, 
and promptly reddens litmus paper. As the watery solution 



692 CREMOR TARTAR. 

tends to spontaneous decomposition in hot weather, it should be 
prepared only as it may be needed. Vogel discovered that borax 
rendered cremor tartar much more soluble in water, and he ima- 
gined that this was a great acquisition. It would have been so, 
probably, if the mixture had not so modified the therapeutic 
qualities as to lessen the value of the medicine. The compound 
is far less diuretic than is the cremor tartar alone. It acts better 
on the bowels, but affects the kidneys very little if at all. 

The alkalies and alkaline earths are incompatible with this salt, 
and so are all the mineral acids. The first two change it to solu- 
ble or neutral tartrate, while the latter decompose it and form 
new salts. The bi-tartrate decomposes the bi-carbonates of potash 
and soda, and hence they are sometimes combined for the purpose 
of making effervescing purgative draughts. The bi-tartrate is also 
employed in preparing the tartrate of potash and iron, tartar 
emetic, and Rochelle salts. 

A fraudulent use is made of cremor tartar by the bakers, who 
resort to the grocers' cream of tartar for the purpose of making 
bread very white. This is a compound of cremor tartar, alum, 
and whiting. (See Bailey's Report on Adulterations.) 

Cremor tartar is not often used as a cathartic by itself, but 
more commonly with flowers of sulphur, jalap, &c. The mixture 
of equal parts of cremor tartar and sulphur, and as much mo- 
lasses as will make a sort of treacle or syrup, is very frequently 
given to children in the spring to purify the blood and clean off 
the skin. A teaspoonful or two every morning proves a gentle 
laxative, and is readily taken, because it is a comparatively plea- 
sant dose. 

The combination of jalap and cremor tartar is much more 
effective. Ten grains of the former and twenty of the latter 
make an ordinary adult dose, which, repeated three or four times 
a day, will induce copious watery or thin discharges. It has 
therefore been denominated a hydragogue cathartic, and is useful 
in some dropsical affections. The dose may be taken in syrup or 
sweetened water. 

A very pleasant drink may be made, partly of cremor tartar, 
that will be found grateful to most persons in warm weather, and 
possessing slight cathartic powers. To make it, 

Take cremor tartar, ^ss ; 
Half a lemon ; 
Honey or sugar, ^ij ; 
Boiling water, a quart. 
Mix these thoroughly, after squeezing the lemon, and drink as often as may 
"be desirable. 

The tartrate can be made by adding sufficient potash to cremor 
tartar and water, in a state of ebullition, to neutralize the excess 



SOLUBLE TARTAR. 693 

of tartaric acid. The whole is to be evaporated and set aside to 
allow of a separation of the tartrate, which from its ready solu- 
bility in water is called soluble tartar. The watery solution is 
liable to spontaneous change in hot weather, and it should not 
be kept in solution at all. 

The neutral tartrate, like the bi-salt, is quite white; but the 
former has not the rough feel of the latter. It is not an un- 
pleasant medicine, and acts very gently on the bowels in half- 
ounce doses. It is well suited to delicate females, and should 
be better known to the profession. 

The incompatibles are magnesia, barytes, lime, acetate of 
lead, nitrate of silver, the acids, acidulous salts, tamarinds, sub- 
acid fruits, &c. The last two neutralize part of the potash, and 
so make the whole a bi-tartrate. Hence it would be improper 
to give soluble tartar in acid drinks that might detach part of 
the potash and so destroy the cathartic quality of the salt. 

We may add soluble tartar to infusion of senna with good 
effect, as it takes away the griping property of the latter and 
renders it more efficient. Joined to powder of rhubarb, calcined 
magnesia, and a few grains of ginger or cinnamon, it consti- 
tutes a convenient and pleasant purgative. The following is a 
good formula, when we use the senna infusion : — 

Take of senna leaves, half an ounce ; 
Ginger, a drachm; 
Boiling water, twelve ounces. 

Macerate these for one hour, and strain through a clean cloth. 
Add to an ounce of the liquor three drachms of soluble tartar 
and two drachms of cinnamon-water, and take the dose an hour 
before eating. The following is also a good cathartic: — 

R. — Pulv. rhei, ^ss; 
Tart. pot. ^i; 
01. menth. p. Vf[uj. 
Mix the powder thus formed in sweetened water or in syrup. 

Dr. Bence Jones has found two drachms of tartrate potash, 
dissolved in four ounces of water, to render the urine alkaline in 
thirty-five minutes. Of course the salt must be decomposed in 
the circulation or elsewhere, before it can furnish free alkali to 
accomplish this result. Other salts of the alkalies act in like 
manner. — Headland's Action of Medicines, p. 143. 

Sulphate of potash has been named as an ingredient in 
Dover's powder. The only reason assigned is its great hard- 
ness, which calls for long and active trituration, and this se- 
cures the proper mixture of the opium and ipecacuanha. As 
the nitrate of potash is much more medicinal than the sulphate, 
some physicians prefer to add it to the opium and ipecacuanha ; 



694 CHLORATE OF POTASH. 

when this is done, more trituration is necessary in order to se- 
cure a perfectly homogeneous result. 

Acetate of potash was, perhaps, the first saline diuretic ever 
employed, and it was known by the name of sal diureticus. It 
is now rarely exhibited in this country, and can well be dis- 
pensed with. Those who desire to use a convenient substitute 
have only to add vinegar or acetic acid to a solution of carbo- 
nate of potash until effervescence ceases. The mixture will 
both purge and act on the kidneys. Two drachms of the car- 
bonate and as much acid as will decompose this much of the 
salt will suffice for one or two doses. 

There are some cases in which it will occur to the practitioner 
that an alkali as well as an eliminative medicine may be called 
for, and then the old-fashioned acetate of potash will be found 
preferable to a free alkali. Skin diseases have been successfully 
treated with this salt, as well as some cases of rheumatism. In 
both instances it acts as a diaphoretic, and so it may correct a 
too acid state of the perspiration, and then pass off as an alka- 
line excretion. In rheumatism it acts as a diuretic, and may 
also counteract the too acid quality of the urine. These facts 
merit a little careful reflection. 

Dr. Golding Bird has found the acetate superior to the nitrate 
of potash, as a depurator or eliminator, in cases of dropsical dis- 
ease. He usually gave a drachm every four hours in a table- 
spoonful of camphor mixture, followed by ten grains of Dover's 
powder at bedtime. — Lond. Lancet, February, 1851. 

Chlorate of potash is a more valuable medicine than the one 
last named, and too little appreciated. One of the latest medi- 
cal dictionaries speaks of it as an alterative and antiscrofulous 
medicine, but adds, "it is of little value." This, for a work of 
1848, is a little behind the age. 

This salt is obtained by passing chlorine gas into a solution 
of fifteen parts of carbonate of potash in thirty-eight of cold 
water until no more can be absorbed or combined. The solu- 
tion is then exposed for a few days to the air, shaking it occa- 
sionally to get rid of the chlorine odor. The crystals that 
are formed must be redissolved in pure boiling water, the solu- 
tion evaporated and set aside to crystallize again. The chlorine 
is converted into chloric acid by decomposition of some water, 
and the acid thus formed combines with the potash to make the 
chlorate. 

This salt was at one time much employed in the treatment 
of pulmonary consumption. Dr. Kolen, of the Berlin Hospital, 
gave it with a pretty liberal hand, and was one of its most san- 
guine admirers. His favorite prescription was as follows : — 



CHLORATE OF POTASH. 695 

R.— Chlor. pot. gi; 
Aq. distill. giv; 
Syr. althaea, ^i. 
Dissolve the first two, and add the syrup named, or any simple syrup. The 
dose is a tablespoonful four times a day. 

Some physicians in this country made repeated trials of the 
chlorate in various forms of the same disease, but not with suffi- 
cient success to warrant us in reposing much confidence in it as a 
means of doing service to consumptive patients. It is decidedly 
stimulant, and may have done harm in many cases. I think it 
has been the occasion of haemoptysis frequently. 

There can be little doubt that a chemico-medical philosophy first 
led to its use in the disease above named, which by many per- 
sons was supposed to be dependent on very defective oxygena- 
tion of the lungs and whole system. The chlorate being a salt 
of high oxygenized qualities, seems to be exactly suited to the 
state of the case, and hence its frequent exhibition. 

In many cases of scarlatina, however, the chlorate is a valu- 
able medicine. I allude, now, not to the simple form of that 
disease, for there little is to be done, but to those cases in which 
there is a manifestation of the typhoid element that seems to 
lay the foundation of a fatal malignancy that resists all ordi- 
nary efforts. In such cases, Dr. Watson, then of King's Col- 
lege, London, tried the following formula : — 

Take of chlorate of potash, gij ; 
Muriatic acid, ^ij; 
Aquas, gij. 

Mix the acid and water, and then add the salt. Put the 
whole into a close bottle and keep it in a dark place. Two 
drachms of the solution mixed with a pint of distilled water 
constitute the proper chlorine medicine for use. The dose is a 
tablespoonful, or two, according to age. Children of from four 
to eight years old may take the doses named two, three, or 
four times a day, or oftener if the symptoms be very alarming. 

This medicine, by its happy stimulation and disinfectant quali- 
ties, seems to be well fitted to counteract the typhoid tendency 
of the disease. The throat is cleansed and the foul odor re- 
moved, and patients improve rapidly under the treatment. 

Additional testimony has been given by several foreign practi- 
tioners in favor of chlorate of potash in the treatment of membra- 
nous formations, and ulcerations of the mouth and thorax, as we 
learn from extracts from a French journal, in the North Amer. 
Med.-Chirurg. Rev. for May, 1857. Its happy effects in some 
cases of scurvy, and in malignant scarlet fever, show pretty 
clearly that it makes a deep impression, and a good one, too, on 
the blood. 



696 FERROCYAN ATE OF POTASH. 

This medicine has come into use also as a remedy for croup. 
It was tried, at first, after the usual means had been carried 
pretty far, and the patient evidently not much better and greatly 
reduced in strength. Several cases are given in point, in neither 
of which, more than a drachm and a half had been consumed. 
As Pereira states that this salt is found unchanged in the blood, 
it might be inferred that no oxygen had been furnished to the 
system by it. He was of opinion, however, that a partial de- 
composition did ensue; otherwise, the change of color from a 
dusky leaden hue to the rosy tint of health could not be ac- 
counted for. — Med. Times and Gazette, July, 1852. 

Phagedenic erosions of the cheeks, sometimes called cancrum 
oris, have been most signally benefited by the chlorate of pot- 
ash. We have already noticed the disputed origin of this state 
of the mouth and cheeks of children, and need not repeat. It 
is more to our present purpose to say that from three to five 
scruples of the salt, given in sweetened water, in the course of 
twenty-four hours, will prove the very best remedy. Experience 
has abundantly tested this fact, no matter what may be the 
theory of the case. 

The same salt has been employed with good results in the 
treatment of unhealthy ulcerations in adults also. The principle 
of action is the same in all cases, most probably. (See the 
London Lancet and Medico-Chirurgical Review for 1843.) It 
is not impossible that the vital forces may eliminate oxygen 
from the salt, or separate its chlorine in such a manner as to 
make the one or the other available. 

M. Bicord has reported very favorably of the use of chlorate 
of potash in mercurial salivation. Not only does it check the 
salivation, but it has appeared to prevent the mercurial action 
altogether, when given very early, so as to merit the title of pro- 
phylactic as well as curative. — Bull, de Therap., Nov. 1856. 

Ferrocyanate of Potash. Prussiate of Potash. — This salt 
has been employed by M. Lombard, of Geneva, as a substitute 
for hydrocyanic acid. He affirms that it possesses all the ad- 
vantages of the acid, and so obviates the necessity of a resort 
to it. He dissolves from one to five grains in an ounce of dis- 
tilled water, and gives a teaspoonful to an adult for a close. 

The same physician employs an ointment of the ferrocyanate 
in the management of neuralgia, the proportions being three 
grains of the salt to an ounce of lard. 

Robiquet advises what he calls the medicinal hydrocyanate 
of potash as a substitute for hydrocyanic acid. To prepare this 
substitute it is necessary first to make the cyanuret of potassium, 
which, having been obtained, is dissolved in eight times its weight 
of pure water, as a consequence of which it is converted into 



POTATO. 697 

medicinal hydrocyanate of potash. This article is employed as 
follows : — 

Take of medicinal hydrocyanate, gi ; 
Pure water, Ibi ; 
White sugar, ^iss. 
Mix, and give five drachms night and morning, as a pectoral. 

A syrup has been made for the same end by adding a drachm 
of the medicinal hydrocyanate to a pound of simple syrup. Mix, 
and gently simmer over a moderate fire. The dose is a table- 
spoonful night and morning. 

We are not disposed to catch at every novel suggestion. But 
in respect of so troublesome a disease as diabetes, we think it 
desirable to give the profession all the helps that are accessible. 
This is not the place to speak of the varieties and nature of dia- 
betes particularly; yet these points must be studied well, in 
order to a wise treatment. We call attention to a new article, 
viz., the permanganate of potash, formed by the union of per- 
manganesic acid and potash. Mr. Sampson speaks very confi- 
dently of the value of this remedy. Two or three grains make 
the usual dose, which may be gradually augmented. A patient 
is named who took eleven grains three times in a day and got 
well rapidly. The safe rule is to increase the dose until it ap- 
pears to disagree with the stomach. 

In patients treated for months in the ordinary way, without 
relief, this medicine, induced a happy change in one week. It 
not only reduces the quantity of urine to its normal state, but 
removes the painful thirst attending this disease. — Lancet, Feb. 
1853. 

Potato. Solarium Tuberosum. — This important vegetable, 
known almost as the staff of life to millions of the race, is also 
entitled to our attention in other relations. The tissue of the 
potato is cellular, and each cell contains about twelve grains of 
starch, and this may account for the result of variable degrees 
of boiling the vegetable. Carried to a certain point, the whole 
interior is mealy or starchy, but pushed too far, it is watery 
and pasty. The constituents of potatoes are starch, a starchy 
fibrin, albumen, gum, acids, salts, and water, and the relative 
proportions of these vary a good deal with season and culture. 
Solanina, the proximate principle of the poisonous bitter sweet, 
(solanum dulcamara,) has also been detected in the potato, and 
especially in the bud and twigs of the plant. Otto supposes this 
to be the cause of disastrous results to cattle and men who have 
eaten of the germinated potatoes. Latham and Nauche have 
obtained a peculiar extract from the leaves and stalks that was 
decidedly poisonous ; and although Dr. Worsham appears to have 
reached a different result, the testimony is in favor of the poison- 

45 



698 POISON OF POTATO. 

ous development, and is confirmed by the previous experiments 
of Otto. (See Journal de Chimie Medicate, vol. vii., and Lon- 
don Medical Transactions, vol. i.) May it not be that the 
potato disease has proved injurious partly by the development 
of solanina, or the poisonous matter referred to by Nauche? 
The investigations into the essential nature of that disease are 
not, to my mind, at all satisfactory, and call for further re- 
search. 

A man, with a large family and no means of support, went to 
some deserted fields to dig small potatoes left in the ground from 
the fall gathering, and rejected by the farmer as unfit for use. 
The potatoes had been frozen, and exposed to the light and 
occasional mid-day warmth, so that their original nutritive pro- 
perties were lost and baneful qualities acquired. They had a 
very bitter taste, and the owner supposed the man was gathering 
them for pigs to eat, hardly thinking them good enough for that 
purpose. The crop thus procured constituted the aliment of the 
family for more than six weeks previous to December, 1832, and 
in that time they had but one meal of any other sort, once in 
eight days. 

Mr. Peddie, who reports the case in the Edinburgh Medical 
and Surgical Journal, vol. xxxix., says that in a very few days 
after using them the whole family complained of severe griping 
pains in the bowels, followed by diarrhoea of a green, watery 
kind. The children were less sorely afflicted, because they par- 
took less of the potatoes, getting occasionally a crust of bread 
from some of the neighbors. 

Although the irritation of the bowels might seem to render the 
poison an irritant one, yet the ultimate action was decidedly nar- 
cotic. The system was depraved, the solids and fluids vitiated, 
gangrene of the face and general dropsy supervened, of which 
two of the family died. 

The importance of the sound potato as a means of preventing 
scurvy, and of curing it after being developed, very greatly en- 
hances its value. It is now known that, in consequence of the 
acid ingredients and other qualities of the potato, it will effectu- 
ally prevent attacks of that disease, and even more certainly if 
combined with vinegar or other vegetable acids. Sound potatoes 
should be taken to sea whole, and also put up in slices in the 
strongest vinegar. We have dwelt sufficiently on the use of acids 
elsewhere, and need not now repeat. 

The anti-scorbutic power of the potato, used as food, has been 
hinted at elsewhere in these pages. It is undoubtedly very im- 
portant. Dr. Baly, physician to the General Penitentiary at 
Milbank, (Eng.,) affirms that the preventive quality is not im- 
paired by a boiling heat, as some have asserted. In 1840, scurvy 



POULTICES. 699 

was a frequent disease among the military prisoners, while it was 
not seen among the convicts. The exemption of the latter was 
owing to the fact that their weekly diet included five pounds of 
potatoes. The military prisoners were then allowed two pounds 
weekly in the first three months, three pounds in the second 
three months, and four pounds after the expiration of six months. 
Not a single case of scurvy occurred among them afterward. 

The presence of citric acid in the potato merits special notice, 
as on it most probably depends, in great measure, the anti-scor- 
butic quality of the vegetable. According to Baup, (a German 
chemist, 1836,) the potato yields enough citric acid to admit of 
its employment for making this acid for commercial purposes. 

Potato starch is much used for dietetical purposes. Being 
void of nitrogen, it is inferior to flour or meal of the cereal 
grains in nutritive power ; but being readily soluble in boiling 
water, it yields several agreeable articles of food. It is sold in 
the shops as potato flour •, potato arrow-root, Bright' s farina, &c. 
&c. Indian corn starch is the potato starch colored blue, very 
slightly. 

Poultices. — Nobody inquires the derivation of this word, be- 
cause everybody knows what we mean by it. If poultices were 
in fashion in Noah's ark, or shortly after the expulsion from the 
garden of Eden, the end in view was probably the same as at 
present. Nature points to a soft, pleasant application to soothe 
pain, allay irritation, and to restore injured tissues to their ori- 
ginal soundness. A poultice does not deserve the name if it be 
uneven, heterogeneous, lumpy, because such properties unfit it 
for use. Suppose the tender breast of a delicate female to re- 
quire such an appliance, common sense would teach that the 
softer, the more emollient and yielding the mass, the better. 
Hence it is important to make a poultice in the best manner 
possible. 

My custom has been, when I needed a bread and milk poultice, 
to boil fresh milk in a clean vessel, and while in the act of ebul- 
lition to throw in gradually finely-grated or powdered stale wheat 
bread, stirring all the while, until enough was added to made the 
whole of a proper consistence. A tablespoonful of fresh lard, 
or as much sweet oil, will be a good addition to a poultice large 
enough for the female breast, and the softness and emollient 
quality will be thus augmented. 

A poultice prepared in this way will be void of lumps, and 
when spread on a cloth it will present an appearance of uni- 
formity. It is the basis of compound poultices, and hence the 
need of making it as it should be. Bark, charcoal, yeast, and 
other articles added to such a poultice will sometimes greatly in- 
crease its value. 



700 PRESCRIPTIONS. 

It is desirable to change poultices twice a day, at least ; in hot 
weather a renewal should be made at noon, as well as in the 
morning and at night. 

Pkescriptions. — Any instruction given by a physician to a 
patient, directly or indirectly, may be called a prescription. 
This may relate to the mind or body, to clothing, traveling, food, 
or physic. But we mean something a little different when we 
talk of prescriptions in the technical sense of the term. Thus 
regarded, a prescription is a special direction for a form of medi- 
cine, simple or compound. Under some circumstances these 
directions are verbal, and frequently the physician prepares the 
medicine with his own hands. In large, or even small cities, it is 
often the business of a physician to write his prescription and 
to direct it to be sent to a particular apothecary to be duly com- 
pounded. Hence the necessity of a proper amount of knowledge 
in order to discharge this duty in the best manner. 

The young physician may say that he is not likely to be ever 
placed in a position where it would be necessary to write a pre- 
scription, since he designs to locate in a country neighborhood. 
But no man can foresee where his lot may be cast five years 
hence; and, therefore, as a city destiny is quite possible when 
least expected, every physician should be ready to write correct 
prescriptions at a moment's warning. And in order to acquire 
the needed facility, it is proper to practice a good deal in private, 
so that, by a sort of instinct or intuition, it may be perfectly easy 
to proportion half a dozen articles with great accuracy, and with- 
out delay or apparent embarrassment. 

To do all this, a man must know and bear in mind for what he 
is to prescribe, and this idea being all the while before him, he 
should reduce the form to paper distinctly, accurately, and intel- 
ligibly to others as well as to himself. To illustrate, it may not 
be amiss to cite a fact. A very fashionable doctor in a Western 
city, known as a perpetual-motion talker, exquisitely polite, and 
fond of the nice things of the table, was requested to see a child 
in a family whose physician he had been for several years. On 
repairing to the house he met the good lady, and felt the child's 
pulse, and made the other customary examinations. The lady 
happened to speak in praise of a dish of which she had eaten but 
recently, and expressed a desire to have the receipt for making 
it. The doctor knew all about it, and, in place of writing a pre- 
scription for the child, deliberately penned nearly half a sheet of 
directions for the pudding. " There, madam," said he, as he 
finished, "there it is. You will please to give one of the powders 
every two hours, until it sickens and purges smartly;" and then 
the gentleman made his best bow and retired. At the same in- 
stant the father entered and inquired what the doctor had ordered 



PRESCRIPTIONS. 701 

for the child. "There is his prescription, my dear," said the 
wife, "and he has told rne how to give the powders." The hus- 
band took the paper for the purpose of sending to his apothe- 
cary, when to his great surprise he found that a pudding and not 
physic had been the theme of the doctor's cogitations. Vexed at 
this strange infatuation, a messenger was sent across the street 
for the late Professor Eberle, who from that day was the phy- 
sician of the family, and from whom I received substantially the 
detail here given. 

The prescriber should write in a plain style, so that a mistake 
could not be made at all without actual criminality. For want 
of care in this respect aqua fontis has been read aqua fortis, 
and with fatal result. The old-fashioned names known to every- 
body are always to be preferred when the articles are very ener- 
getic ; as, for instance, calomel and corrosive sublimate, rather 
than the modern technicalities. 

The physician who writes a prescription should never send it 
out so that an apothecary may take the liberty of guessing what 
the writer meant. For instance, I have seen a prescription for 
a drachm of blue mass to be made into pills, thus : — 

R. — Blue mass, ^i. 
To be made into pills. 

Here it is obvious that the apothecary was to decide the number 
of pills to be made, and, of course, their weight. And if this 
may be done in respect of blue mass, why not in regard to cor- 
rosive sublimate or strychnia ? 

We are told by an English surgeon, Mr. Henle, in the London 
Lancet for June, 1846, that a practitioner of some note actually 
wrote a prescription and sent it to an apothecary to be com 
pounded, ending with — 

Liquor potassse arsenitis, quantum sufficit! 

Could a man be sane who would allow his apothecary such a 
latitude with such an agent ? Degraded as the profession is said 
to be in America, I have never seen anything equal to this. 

It is not possible to be too careful in this part of professional 
duty ; and it is a good rule not to let a prescription pass from the 
hand until read over a second time. Many facts could be nar- 
rated having an important bearing here, but it would seem to be 
unnecessary to go into detail. 

As a general rule, a prescription should not contain more than 
four or five articles, and never should it exceed six. The late 
Dr. Chovet, an Italian, who was well known in this city sixty 
years ago, was in the habit of putting twenty and sometimes 
twenty-five ingredients into one prescription. He believed that 



702 PREVENTIVE TREATMENT. 

the practice of medicine was often a random business, and a good 
deal like shooting at a great flock of reed birds with a double 
load of fine shot. Although aimed at no single object, it was 
probable some of the three or four hundred shot would hit. He 
judged of his compound physic in the same way, and cared not 
which of the twenty articles hit the disease, provided the patient 
was the better for the dose. 

The prescriptions given in this work are purposely written in 
the usual abbreviated Latin and full English styles ; and I care 
not which is adopted, though inclined to believe that the welfare 
of the community would be most happily consulted by using plain 
English. Enough are presented to enable the young practitioner 
to become familiar with the writing or directing of prescriptions 
for any ordinary purpose. When there is no valid plea for the 
concealment or disguise of the remedial agents, there can be no 
sufficient reason assigned for a preference of the Latin language 
in our instruction to the apothecary. There is one method of 
writing prescriptions which should be discountenanced every- 
where. I allude to the use 6f hieroglyphics not known to any 
of the books, and understood only by the prescribing physician 
and his apothecary. I say his apothecary, for no other in the 
place could decipher one of the prescriptions from such a source. 
The secret contrivance is adopted by the parties for their mutual 
profit ; and when the physician has a large practice and under- 
stands how to multiply prescriptions, the clear gain is by no 
means inconsiderable. But such tricks are plainly disgraceful to 
an honorable and liberal profession, although not in conflict with 
any existing civil statute. 

Preventive Treatment. — This is quite too much overlooked 
by the profession. In fact, it is not always in our power to meet 
cases of diseases in time to apply preventive means. The late 
Professor Rush was very emphatic in his teachings on this point, 
and hence the interest with which he dwelt on the forming state 
of fevers^ the premonitory signs of disease, and the great advan- 
tage of meeting cases just at these epochs in their history. An 
emetic, or a cathartic, or a small bleeding, or abstinence, or 
quietude, may arrest a disease in its formative state, and com- 
pletely break it up. Who has not learned that the surest way to 
meet Asiatic cholera is by absolute rest and a very little medi- 
cine when the first manifestations of looseness appear? And 
who does not know that a full seizure of sthenic apoplexy may be 
prevented by bleeding, purging, abstinence, cold to the head, &c? 
In females with great liability to abort, we see daily the great 
advantage of absolute rest, a cooling diet and regimen, begun 
and carried out as soon as possible after conception, and even 
when no sign of abortion is perceptible. 



PROTEINE— WILD CHERRY. 703 

Proteine. — This is from the Greek, and means to hold the 
first place. — It is the basis of albumen, fibrin, casein, and other 
important and nutritious azotized principles. It is introduced 
here because a writer has suggested the importance of its ad- 
ministration to debilitated subjects as a direct means of nutrition. 
Whether the plan will ever be regarded as an important matter, 
time must determine. The article is now prepared and kept on 
sale, and it may be well to give it a trial occasionally. It is ob- 
tained by dissolving the substances above named in potash, by 
a gentle heat, so as entirely to separate their sulphur ; after 
which acetic acid is added, in order to throw down the proteine. 
When perfectly dried, this product looks somewhat like trans- 
parent horn, though far more brittle, and hence reducible to 
powder. Previous to the act of drying, it is a grayish-looking, 
gelatinous mass. 

The discoverer (Mulder) gives its composition as made up of 
carbon, 40 ; hydrogen, 31 ; nitrogen, 5 ; and oxygen, 12. To 
this the suggestions of Liebig pretty closely conform ; his varia- 
tions being merely a matter of expediency for theoretical purposes. 

As proteine is clearly the foundation of all the nitrogenized 
animal tissues, it is plain that its use as an article of diet has a 
philosophical basis. Its composition, moreover, aids us in deter- 
mining the actual alimentary qualities of various articles of food. 
Its very ready solubility in acids found in the animal economy, 
as the acetic and phosphoric, prove its adaptedness as a means 
of nutrition. 

Proteine has been introduced to our notice as an article of 
Materia Medica, and promises to be very useful. E. W. Tusson, 
surgeon to Middlesex Hospital, has succeeded with it in caries 
and ulcers, in ten-grain doses, given twice a day for two months. 
The healing process was rapid and perfect, though previously the 
cases were exceedingly obstinate. — Braithwaite, part xvii. We 
suggest the importance of trying it fairly. 

Not a few interesting cases of scrofula appear to have been 
entirely cured by the use of proteine. Of these we may cite 
some furnished by J. Taylor, Esq., in the Lancet for Sept. 24, 
1853. The patients were from two to five years old, and the 
disease was hereditary. Three grains were given in sugar and 
water three times a day, and increased to five-grain doses in the 
course of a month. The ulcers were dressed with zinc ointment 
and an occasional poultice of flaxseed. Some of the cases im- 
proved very obviously in a few weeks. — Braithwaite, part xxvii. 
p. 38. 

Prunits YirginianA. Wild Cherry. The bark and berries. 
— This tree is universally known in the United States, and there- 
fore we are not about to describe it. The cherries or berries are 



704 PULSATILLA — POWDERS. 

deemed more valuable as a medicine than the bark, bj some in- 
dividuals. Both contain, beyond doubt, a small portion of hydro- 
cyanic acid, and the modified state of the acid is the secret of 
any good effects that may result from their use. The cherries 
are generally made into a sort of tincture or cordial by the 
addition of brandy. The inner bark, in form of infusion, pre- 
sents a safer expedient, and is equally valuable. An ounce of 
this bark to a quart of cold water, allowed to stand undisturbed 
all night, will present a very good form for exhibiting the wild 
cherry. A little orange or lemon-peel may be added, if desirable. 
The infusion may be taken ad libitum, and is gently tonic and 
expectorant. A strong decoction is sometimes applied to in- 
dolent ulcers and herpetic eruptions, and is also the basis of an 
excellent expectorant syrup. (See the article Syrups.) 

Pulsatilla. — This is one of the items on which part of the 
mysticism of the infinitesimal practice depends. An effort has 
been repeatedly made to induce the belief among the non-pro- 
fessional that all the medicines employed by this dreamy philo- 
sophy are different, as to source, nature, and everything else, 
from those exhibited by the regular practitioners. And yet it 
is really true that the latter employed every article known to 
the former for centuries before Hahnemann was born. Pul- 
satilla is a species of anemony. Pulsatilla nigricans is the 
anemone pratensis of the old books, and was a favorite with 
Baron Stoerck in chronic diseases of the eyes, secondary syphilis, 
and cutaneous affections. He regarded it as possessed of extra- 
ordinary virtues ; but his cotemporaries valued it so lightly that 
it fell into disuse. It has acrid properties, and when chewed in- 
flames the mouth and tongue, inducing an increase of the sali- 
vary discharge, on which account it has been employed for the 
relief of toothache. 

We give these brief notices merely to put our junior readers 
on their guard when accosted, as they will be occasionally, touch- 
ing the wonderful discoveries of the Hahnemann school. 

Pulveres. Powders. — This is, beyond doubt, a most excel- 
lent mode for the exhibition of many medicines. We prefer it 
when the powders are not large, and the patient can take them 
without difficulty. The following formulae will be useful to the 
practitioner : — 

Compound Powder of Belladonna. Aperient Powder. 
R. — Pulv. fol. belladon. grs. ij ; R. — Pulv. jalap, giij ; 
" moschi, Cal. ppt. gi; 
" camphorse, aa grs. v; Pulv. zingib. J}ij. 
" sacch. alb. £ss. Mix. Dose, from eight to twenty- 
Rub well together, and divide into five grains, in syrup of lemon or 
eight powders. (Used in pertussis, ginger, 
asthma, &c. ) 



POWDERS. 



705 



Tonic Powders. 

1. R. — Pulv. rad. calumb. 

" rad. zingib. 
" carb. ferri, aa gi. 
Rub together, and make twelve pow- 
ders. Dose, one three times a day. 

2. R.— Sulph. quin. £i; 

Pulv. gentian, giij ; 
Ferri. sulph. £i ; 
Ferri carb. ^iss. 
Mix. To make sixty powders. Take 
one three times a day. 

Camphor Powder. 

R. — Camphorse, gss ; 

Alcohol, q. s. to reduce to 

powder. 
Sacch. alb. ^i ; 
Pulv. gum Arab. giss. 
Mix, and divide into ten parts. 

Carminative Powders. 

1. R. — Magnes. calc. grs. x; 

Sem. anis. contus. 

Sem. foenic. contus. 

Sem. cardam. contus. aagrs. iij; 

Sacch. alb. grs. x. 
Rub to fine powder. Divide into two 
closes, to be given half an hour apart. 
(For children.) 

2. R. — Pulv. cort. aurant. 

" rad. zingib. aagvi; 
" nuc. moschat. gij ; 
" cret. prep. %i; 
Magnes. calc. |jss ; 
Sacch. alb. ^i. 
Mix intimately. Dose, a teaspoonful 
or two, three times a day. (For adults. ) 

Chalk Powder. 

R. — Cret. prepar. 

Pulv. gum Arab, aa ^ij ; 

Sacch. alb. ^iss. 
Mix. Dose for an adult, a teaspoon- 
ful. 

Compound Powder of Rhubarb. 

R. — Pulv. rhei, ^i; 

Hydrarg. cum cret. ^i; 
Sacch. alb. ^ij ; 
01. foenic. dulc. 1T(v ; 
Cret. prep. gss. 
Rub well together. Dose, from five 
to thirty grains, in syrup, two or three 
times a day. (For infantile diarrhoea.) 



Compound Jalap Powders. 

1. R. — Pulv. rad. jalap, ^i; 

Potass, bitart. ^ij ; 
Pulv. capsici an. grs. x. 
Rub intimately. Dose, thirty to 
sixty grains, in the morning, in syrup 

2. R. — Pulv. R. jalap, grs. xv; 

Cal. ppt. grs. v ; 

Sacch. alb. ^ss. 
Rub these intimately, and add 

01. carui, ftl ij ; 

Pulv. gum. Arab, ^i. 
Mix. Take at one dose, in syrup. 

Stimulant Powder. (Hartman's.) 

R. — Sodse bibor. £)i; 

Pulv. sabinse, grs. vi ; 
" castor. 

" zingib. aa grs. x. 
Mix, and take it for a dose, twice a 
day, in honey or syrup. 

Purging Powders. 

1. R.— Cal. ppt. 

Pulv. cambog. 

" zingib. aa gss ; 
Sacch. alb. J}i; 
01. foenic. d. 1T|xx. 
Rub well together. Dose, ten to 
thirty grains. 

2. R. — Pulv. rhei, giiiss; 

Hydrarg. cum cret. gi ; 
Potass, carb. sjiss ; 
Pulv. cinnam. gss. 
Mix well. Dose, from five to twenty 
grains two or three times a day. 

3. R. — Pulv. rhei, 5s s ; 

Magnes. carb. grs. xx; 
Sacch. alb. grs. x ; 
01. cinnam. TTI ij. 
Mix, to make one powder. 

4. R. — Pulv. scammon. ^ij ; 

Cal. ppt. 

Sacch. alb. aa 3L 
Mix well. Dose, ten to twenty grains, 
in the morning. 

5. R. — Pulv. scammon. grs. xij ; 

" jalap, grs. xiij ; 
Pot. bitart. grs. xxv. 
Rub these well together, and add 

Pulv. zingib. grs. viij. 
Mix, and divide into three parts. 
Take one every third hour, in syrup. 



706 PUMPKIN SEED — RIND OF THE POMEGRANATE. 

Compound Zinc Powders. Compound Saline Powder. 

1. R.— Pulv. valerian, gij ; R.— Potass, chlorat. grs. x; 

Zinc. oxyd. gi ; s d£e chlorid. liq. grs. v ; 

Moschi, « bi-carb. grs. xij ; 

Sacch. alb. aa grs. x; 01. cajeput. Iflnj. 

01. cajeput. ir[x. Mix To be taken in barley-water. 

Rub well together, and make six 

doses, one to be taken three times a „ 7 „ 7 . ~ 7 , , 

j Compound Powder of saltpetre. 

2. R.— Zinc, oxyd. grs. xij ; R.— Nit. potass, grs. x; 

Magnes. calc. ^ss ; Pulv - cmnam. grs. v ; 

Pulv. calumb. gi, " ipecac, gr. i ; 

Mix well, and make twelve powders. ^ * "t ' 

One to be taken three or four times a Mix for a dose - Take {t tnree or four 

day. times a day. (Diarrhoea, dysentery.) 

Gum my?rh. g ?i'; V1 ' Compound Valerian Powder. 

Pulv. ipecac, grs. vi; R. — Pulv. valerian, ^i; 

" glycirrh. Magnes. calc. 

Sacch. alb. aa giss. Ammon. hydroch. aa grs. v ; 

Rub intimately. Divide into nine 0L cajeput. T^j- 
parts. Take one three or four times a Mix, and divide into two parts. 
day. 

Pumpkin Seed. — These are so common that every one knows 
what is meant quite as well, and better than if we had written 
semines peponis. The late Prof. Patterson, of the Pennsylvania 
Med. College, reported a case of toenia permanently cured by the 
use of an emulsion of the seeds of the pumpkin, after turpentine 
and kousso had signally failed. The seeds yield a fixed oil, 
which may be given in half-ounce doses twice a day, followed 
with an ounce of castor oil. The first case was reported in 1852, 
and we call the attention of physicians specially to the facts. 

Punic^i Granati Tunica. Rind of the Pomegranate. Rind 
of the fruit. — The flowers have also been employed medicinally, 
both internally and externally. Celsus, who wrote in the four- 
teenth century, speaks in praise of a decoction of the small 
tendrils of the pomegranate as a remedy for tapeworm, the pre- 
cise disease for which it has ever since been prescribed in various 
countries. The rind is slightly astringent, and this feature ex- 
plains the reason of its use in certain forms of disease for which 
more decided astringents are prescribed. 

The powder and decoction have both been employed in view 
of its anthelmintic operation. The dose of the powder is a 
scruple every hour until five or six doses have been taken. The 
decoction is prepared by boiling two ounces of the fresh rind in 
a quart of water until reduced to a pint. A wineglassful should 
be given every half-hour until five portions have been swallowed ; 
and this quantity is affirmed to suffice for the expulsion of the 
whole or part of the tapeworm. It is a very safe remedy for 



PURE CHEMICALS — WINTER GREEN. 707 

persons of all ages. A child only fourteen months old took it 
with benefit. Six ounces of the decoction, prepared as above, 
were mixed with two ounces of water, and a tablespoonful given 
every half-hour until vomiting ensued. Quite a large tapeworm 
was expelled. 

The pomegranate is an ancient remedy for chronic diarrhoea 
and the last stage of dysentery. It has been frequently exhibited 
as an injection in leucorrhoea, and very often employed as a 
gargle to remove unpleasant relaxation and debility of the uvula 
and fauces. In all these cases it is supposed to act in virtue of 
its astringency. 

The best bark or rind is entirely free of worm-holes ; and the 
sounder it is the better. 

Pure Chemicals. — It affords us much pleasure to learn that 
our own manufacturing chemists are paying special attention to 
the formation of elegant chemicals, and are furnishing proximate 
principles and rare articles of Materia Medica in a pure state. 
Thus codeia, morphia, quinodine, cinchonine, &c. are manufac- 
tured by Messrs. Powers and Weightman. An elegant article of 
piperine, valerianate, and nitrate of morphia, nitrate and acetate 
of strychnia, with many others, are prepared in elegant style by 
Messrs. Rosengarten and Sons. Amylene, valerianic acid, vale- 
rianate of ammonia, iodoform, and ethyl are furnished by Hennel, 
Stevens & Co. ; while pyro-gallic acid, bromide and iodide of cad- 
mium, bromide and iodide of ammonium, and nitrate of magnesia 
come from the laboratory of Garrigues, Magee and Meyer ; the 
house of Bullock and Crenshaw producing the bi-sulphuret of tin, 
oxides of nickel, sulphate and carbonate of nickel, molybdate of 
ammonia, &c. &c. We trust that all our manufacturers of fine 
articles of Materia Medica will be abundantly rewarded for their 
industry and enterprise, and that the imaginary necessity of 
going abroad for such items may soon be annihilated. American 
ingenuity can do anything that falls within the province of man 
to achieve. 

Pyri Cydonis Semina. Quince Seeds.— These contain a 
large quantity of mucilage. To detach it, add one part of the 
seeds to three of cold water, which readily detaches the mucilage ; 
this is nearly as viscid as mucilage of gum Arabic. It is a 
very soothing application to the eye, when inflamed, especially 
after free depletion has reduced the inflammation to the subacute 
state. It makes a good drink for persons laboring under irrita- 
bility of the bowels, the bladder, &c. One or two tablespoon- 
fuls should be added to a pint of pure water for this purpose. 

Pyrola Umbellata. Pipsissewa. Winter Gfreen. — This is 
a very common plant in the United States, and looks a good deal 
like uva ursi, and the leaves are somewhat like those of the 



708 QUASSIA. 

garden box-plant. A good infusion is made of an ounce of the 
leaves and a pint of boiling water. A wineglassful may be taken 
frequently through the day, and will be found to act as a diuretic. 
On account of its bitterness it is sometimes called a tonic diu- 
retic. It rarely offends the stomach, and often improves its tone 
and increases the digestive powers. The diuretic effect is pro- 
moted by dissolving a drachm of nitrate of potash in a pint of 
the infusion. Formerly this plant was held to be a kind of spe- 
cific or panacea in dropsy, rheumatism, and cutaneous diseases. 
Its powers have been overrated, and the most that can be justly 
said is, that it is a good diuretic. The bruised leaves, in form of 
poultice, have been usefully applied to hard and painful tumors. 

Quassia. Quassia Excelsa. — This wood is obtained from the 
West Indies, sometimes rasped, chipped, or ground, but generally 
in billets. It is properly regarded as the purest bitter we possess, 
and hence its popularity. The bitterness is very intense, and 
easily imparted to water, cold or hot. If two drachms or half an 
ounce be added to a pint of boiling water, macerated and 
strained, we have a good infusion. If we need the infusion for 
very delicate stomachs, it is best made of cold water. Half an 
ounce of the rasped or ground quassia in a pint of cold water, 
after twelve hours maceration, will give a more suitable article, 
because the cold water does not dissolve the extractive matter. 
A wineglass half full may be taken three times a clay, or oftener, 
alone or with a little ginger tea. For feeble, emaciated per- 
sons with impaired digestive organs, this will be found a good 
article. 

Quassia was first introduced into use as a medicinal agent by 
a sort of casualty. A negro named Quassi labored under fever, 
probably an intermittent, and was greatly relieved by drinking 
of water made bitter by the leaves which fell from the quassia- 
tree. And although we do not now concede any peculiar anti- 
periodic power to it, all regard it as an excellent tonic. It does 
not accelerate the pulse, nor increase animal heat, nor disturb the 
bowels. Its alleged vermifuge power depends chiefly on its 
tonic action. A strong infusion has been employed as an in- 
jection for the expulsion of ascarides. (See Ranking, vol. ii. 
No. 2.) 

In South America, bowls have been made of the wood suitable 
for holding water, to be drank after standing some hours in the 
vessel, as a remedy for dyspepsia. And if such patients could 
be persuaded to drink nothing else, the prescription would be 
more frequently salutary. The drink may be regarded as a cold 
infusion of quassia. 

A very convenient vessel has been made in this city by turning 
a piece of quassia wood into a kind of goblet. It is known as the 



USES OF OAK BARK. 709 

quassia cup. If it is filled with cold water the contents will be 
found bitter enough in less than an hour. Many persons prefer 
this to all other modes of using the quassia. It is a very simple, 
convenient, and efficient mode of using a pure bitter. 

This infusion has an advantage over other bitter infusions in 
respect of its compatibility with salts of iron. Ten or twenty 
grains of the green sulphate of iron added to a pint of quassia 
infusion will not change the color, while the tonic power is 
augmented. 

The extract of quassia is an excellent article, both as a tonic 
and also because it helps to make good pills of articles that are 
not well managed without such aid ; as, for example, the sul- 
phate of iron. The tonic power of the medicine is in a con- 
densed form, and free from liquid addition that is offensive to many 
persons. It is made by boiling one or two pounds of the rasped 
quassia in a gallon of water until four pints remain. Strain 
while hot, and evaporate to the consistency of extract. Three 
pills, containing one grain each, may be taken three or four times 
daily. 

A proximate principle called quassine has been named, but it 
is really of no value. 

Quassia simarouba and quassia amara are spoken of in the 
books ; but the excelsa meets all the wants of practical medicine. 
We may as well notice an additional use of quassia infusion, 
spoken of by Mr, Brande, the author of a good book on Che- 
mistry. He states that the infusion, made pretty sweet with 
brown sugar, is an effectual poison for flies, and far preferable 
to the poisonous articles employed for the same end. Those who 
are troubled much with these little pests would do well to try the 
bane. 

Quercus. OaTc. — If the oak was less common and abundant, 
if in place of scores of varieties we had but one, every portion 
of the tree would be prized by many who seldom trouble them- 
selves about it. The noted astringency of the oaks, the large 
quantity of tannin they contain, entitle them to consideration 
for their medicinal virtues ; and hence they were formerly re- 
sorted to as substitutes for Peruvian bark. The late Professor 
Rush treated many cases of intermittents successfully with 
ground oak bark alone ; and doubtless the same thing could be 
accomplished now. Some have combined dogwood bark with oak 
bark and snakeroot, very advantageously, in the form of infusion. 
It is well for medical men who rely on the sulphate of quinine 
because easily obtained, to bear in mind all the substitutes for it, 
since the time may come when neither Peruvian bark nor its alka- 
loids can be procured. It is true that we must give more oak 



710 USES OF OAK BARK — QUINODINE. 

than Peruvian bark to cure an ague and fever, but its cheapness 
will allow it to be given without stint. 

Infusion of oak bark administered internally, and a daily im- 
mersion of the body in a very strong bath of the bark, have 
frequently arrested cholera infantum. This disease sometimes 
depends on pure debility, and such cases are happily met by 
these expedients. An English surgeon tells rather an amusing 
yet instructive story in the London Lancet for April, 1850, 
respecting the efficiency of oak bark in restraining intestinal 
discharges. The patient had been delivered about a fortnight 
before, and suffered from very frequent discharges per anum, 
and considerable bearing down efforts. The surgeon gave a pre- 
scription for a chalk julep containing laudanum to be taken by 
the mouth; and an injection of oak bark and alum to be thrown 
into the vagina. Three days after this, he was greatly surprised 
at her improvement, and learned that the julep had been thrown 
into the vagina, while the oak bark decoction of twenty-four 
ounces had been swallowed in the course of the day. An ounce 
and a half of the bark and five grains of alum were thus taken 
every four hours. The diarrhoea promptly ceased. A strong 
infusion or decoction will be found useful to feeble ulcers whose 
vessels tend to bleed from very slight causes. For the relief of 
relaxation of the fauces, we shall find the oak bark tea to be 
one of our best gargles. It should be employed repeatedly. I 
have been much pleased with the effect of the same article, ap- 
plied for the relief of prolapsus ani and hemorrhoidal tumors. 
Injections of the infusion have been frequently employed in 
leucorrhoea and uterine hemorrhage, with great relaxation of the 
parts, and very successfully. It will sometimes be found that 
tinea capitis is protracted because of debility in the vessels of 
the scalp, which may be subdued by daily lotions of strong oak 
bark decoction. 

Quinodine. This alkaloid is obtained from what is called "a 
new Bogota bark," named by some writers, " China Bogotensis." 
The new alkaloid is reported to differ from quinine chiefly in 
being less efficient as an antiperiodic. Dr. Foote, of Texas, has 
reported a number of cases treated with this article. He says 
it does not affect the head as unpleasantly as the salts of quinine, 
although given in larger doses. He thinks its antiperiodic powers 
are very great, while it is less expensive than the more fashion- 
able product of Peruvian bark. The sulphate of quinodine is the 
preparation most in use. — Dublin Hospital Gazette, Jan. 1856. 

Agreeably to Liebig, (see London Lancet, May, 1846,) quino- 
dine is merely quinine in the amorphous or uncrystallized form, 
and convertible into the salts of the latter. 

Dr. Graham, of North Carolina, has reported favorably of the 



READY METHOD — EHATANY. 711 

use of this article, in the North American Medico- Cliirurgical 
Revieiv for May, 1857. He regards it as a good tonic, and, in 
connection with iodine and ipecacuanha, an excellent alterative. 
But he holds it to be specially valuable in malarious fevers, 
and thinks that few who try it would be willing to lay it aside 
for quinine. He gives it in two-grain doses in form of pill, and 
says that each patient will require from thirty to forty grains. 

Ready Method. — We do not like this term, but as it finds a 
place in several papers furnished by Dr. Marshal Hall to the 
journals abroad, it is, perhaps, necessary to speak of it here. 
It is his expedient for restoring suspended respiration in cases 
of asphyxia in new-born infants and older persons. Protesting 
against all efforts while the body is in the supine posture, that is, 
on the back, because necessarily worse than useless, he insists on 
the prone posture, that is, the face down. The body is to be 
rotated, occasionally pressing the hands on the sides and back, 
and alternately sprinkling cold and warm water on the surface. 
This expedient must be persisted in a good while. The warm- 
bath practice is held to be fatal by this writer necessarily. 

Resina Flava. Yellow Resin. — This article remains in the 
still after distilling oil of turpentine from common turpentine 
mixed with water, and is therefore a product of the pinus syl- 
vestris. 

The powder of the yellow resin, or rosin, is sometimes ad- 
ministered as a remedy for chronic rheumatism, in doses of from 
twenty to thirty grains in molasses, and taken several times a 
day. It has also been employed in asthma as an expectorant. 

It enters into the composition of the ceratum resince, or the 
basilicon ointment: — 

Take of yellow resin, ^v; 
Yellow wax, Hjij; 
Lard, gviij. 

Melt these articles over a slow fire, and pour into a clean stone 
or earthen jar, furnished with a tight cover. The cerate or oint- 
ment is a popular dressing to blistered surfaces, and serves to 
increase the discharge. Rubbed on a tile with as much spirits 
of turpentine as can be blended with it by means of a spatula, 
it furnishes the celebrated Kentish salve, or ointment for burns 
and scalds. In the use of this ointment, care should be taken 
to cover only the surface that has been burned. It is soothing 
to the burnt part, but exceedingly irritant to the sound skin. 
The patient will sometimes fall asleep in a few minutes after the 
application has been made. 

Rhatany. The root. Kramerice Triandrio2 Radix. Rha- 
tanhia. — The various spelling of this word is not of very great 
moment if its medicinal value be duly appreciated. The word 



712 USES OF RHATANY. 

rhatanhia, or ratanhia, means spreading, and is employed to 
denote the fact that the root spreads out very much and traverses 
a good deal of soil. The plant is a native of Peru, and grows 
in arid, sandy places. The root is of variable thickness, having 
a dark-red color, a short, abrupt fracture, and revealing, when 
broken, a woody centre with a fibrous bark, which is readily sepa- 
rated, and is found to contain the active properties of the root. 
The woody portion is wholly inert. 

The small roots are generally held to be the best, because 
their relative portion of bark is greater than in the large roots. 
The bark is bitter, astringent, a little nauseating, with some- 
what of a sweetish taste. The odor is earthy, and the decoc- 
tion has the peculiar smell of raw potatoes. The bruised root 
yields to boiling water a reddish-brown infusion, which is darkened 
by the addition of an alkali. The astringency of rhatany depends 
chiefly on tannin, and on many accounts it is probably one of 
our best astringents. Alcohol takes up the coloring matter, and 
part of the tannin, and also some resin. The Portuguese avail 
themselves of the coloring and astringency of this article for 
the purpose of improving their red wines ; and it is probably a 
less hurtful addition than some articles that are frequently em- 
ployed by the manufacturers of wine. The saturated tincture 
of the root is known among them .by the name of ivine-coloring . 

If the root be digested in sulphuric acid, a brown extract is 
obtained that is quite soluble in distilled water, and when applied 
to the tongue gives a sensation of high astringency. This pro- 
duct has been used medicinally for the objects that are met by 
astringents generally; but I am not aware that it has any pecu- 
liar merits. The St. Louis Medical and Surgical Journal con- 
tains some facts in this relation. 

The rhatany root has been employed in Peru as a tonic merely, 
as well as an astringent, and it is affirmed that it may always be 
given when tonics are proper. 

One of the most common uses of this medicine has been in 
dysentery and diarrhoea. It was employed in the former disease 
in Peru, after inflammation had been wholly subdued, and when, 
probably, a state of relaxation remained. I have never tried it 
under such circumstances, but I esteem it a most valuable article 
in the treatment of chronic diarrhoea. The prescription which 
I have employed is as follows : — 

R. — Ext. rhatan. gi; 

Acid nitric, Tfyxxiv; 
Sacch. alb. gi; 
Tinct. opii, £ss; 
Aq. canrphorat. ^iv. 

Mix. 



USES OF RHATANY. 713 

The dose for an adult is a tablespoon half full three times a 
day, or oftener if occasion seem to require. I have found this 
mixture of special value in that sort of looseness brought on by 
a change of water and general living, so often met with in Lex- 
ington, Ky., and elsewhere, among medical students who have 
traveled several hundred miles, and with very changeful diet on 
the route. The good effect of the medicine is noticed after three 
or four doses have been taken. 

The extract named is kept in all well-ordered drug stores, and 
is a very convenient and useful preparation. It is made from a 
very strong decoction of the root, as other vegetable extracts 
are formed. It will keep in any climate. 

Thompson prefers the infusion and decoction of the root. The 
former is made by digesting an ounce of the bruised root in a 
pint of hot water, and the dose is two ounces three or four times 
a day. The decoction is made by boiling two ounces of the 
bruised root in a pint of water. A tincture has also been made, 
but it is unnecessary, and rarely exhibited. It can be formed by 
digesting for two weeks an ounce of the root in a pint of brandy. 
A tablespoonful of this makes an adult dose. 

All the above preparations have been employed in hemorrhages, 
especially of the passive kind, and those of the mucous mem- 
branes in particular. They have been administered successfully 
in uterine hemorrhage in feeble constitutions. Sir Henry Hal- 
ford speaks highly of rhatany in this relation, and he sometimes 
gave the powder of the root as well as the infusion, the dose 
varying from ten to thirty grains thrice a day. 

M. Chauffard, physician to a French hospital, gave rhatany 
with marked success in a case of threatened abortion. The 
lady had miscarried twice, though bled and kept in a horizontal 
posture. She took, in less than sixty hours, one hundred and 
thirty-two grains of rhatany root, with twelve grains of alum. 
The hemorrhage was arrested, the patient passed safely through 
the period of utero-gestation, and had a healthy child. 

The infusion has been employed as a gargle for relaxation of 
the fauces, and as a collyrium for chronic ophthalmia, and as an 
injection in gonorrhoea and leucorrhoea. Fissure of the anus in 
infants has been cured by injections of rhatany and by frequent 
washings with it ; and the same treatment has been successful in 
fissure of the rectum in adults. (See BelVs Bulletin of Medi- 
cal Sciences, 1846, and American Journal of Medical Sciences, 
1841.) 

' Rhatany and chloride of lime have been combined in the treat- 
ment of ozena, with very foul discharge from the nose. This 
disease is sometimes very obstinate, and baffles medical skill. 
If there be a scrofulous taint in the system, it cannot be cured 

46 



714 VARIETIES OF RHUBARB. 

without superadding some iodine preparation. In uncomplicated 
cases, the following will frequently succeed: — 

R. — Chloride of lime, gij ; 

Decoction of rhatany, ^xij. 

Rub these well together in a mortar, so as to make a homo- 
geneous mixture. Bottle it, and keep it well stoppered. Let a 
tablespoonful be injected into the nasal passages three or four 
times a day. A long-pointed syringe answers best for this opera- 
tion. (See Amer. Med. Journal, 1842.) 

The physician who administers any preparation of rhatany in- 
ternally should apprise his patients that the faeces will be tinged 
of a deep red, having some resemblance to admixture with blood ; 
and that even after the medicine has been laid aside the same 
appearance may be visible a few days. The urine is not affected 
at all, but the long-continued use of the article may induce flying 
pains of the limbs, costiveness, abdominal disquiet, and even some 
spitting of blood. When any of these occur, the medicine should 
be discontinued at least for a few days. 

Rhei Radix. Root of Rheum Palmatum. — Though rhubarb 
is a native of China and Tartary, it may be cultivated almost 
anywhere in a mild climate. The rhaponticum is the variety 
usually cultivated for the stalks, which are an excellent substitute 
for acid fruits, as currants, gooseberries, &c, that are not yet 
ripe nor fit for use. Dr. Prout speaks of well-marked cases of 
nephritic attacks in persons who had the oxalate of lime diathesis, 
brought on by the free use of rhubarb tarts ; and he adds that 
this result is the more likely if hard water be the usual drink of 
the patient. This is owing to the presence of a good deal of 
oxalic acid in the rhubarb plant. To such an extent does this 
obtain in some localities, that symptoms of acrid poisoning have 
been induced by the tarts when eaten largely. The species 
whence medicinal rhubarb is obtained is perhaps a matter of un- 
certainty, and is of very little importance. All the varieties of 
rhubarb are affirmed to come from a common source; and even 
that point is not determined. The Russia and Turkey rhubarb 
are held to be the finest and best sorts, while the East India 
article is said to be of inferior quality. The sounder and freer 
of worm-holes the better is the rhubarb, no matter whence it 
comes. 

The best rhubarb, when fractured, has a mottled texture, with 
streaks of red and gray. The odor of rhubarb is not very strong, 
yet peculiar ; its taste bitter and slightly astringent. The color 
of good rhubarb is of a reddish-yellow, and its texture is compact. 
The powder of pure, unmixed rhubarb is of a bright yellow, in- 
clining to buff. A vast deal of the powder of rhubarb sold in 



VARIETIES OF RHUBARB. 715 

our large cities is a compound of all kinds of defective, unsound, 
and spoiled rhubarb. I knew a man, many years ago, who bought 
all the worm-eaten, decayed rhubard he could find, and had the 
whole ground up with a small portion of good root. He was able 
to vend this manufactured rhubarb powder at a comparatively 
small price ; and thus a most inferior article was widely circu- 
lated that had little or no medicinal power. 

This home fraud practiced in the large cities is bad enough ; 
and yet a foreign cheat is carried on that greatly magnifies the 
evil. No less than fifteen thousand pounds of spurious rhubarb 
were condemned in the port of New York in the space of six 
months by the government medical inspector, which had been im- 
ported from Canton, London, and Marseilles.* 

Rhubarb is soluble in water as well as in alcohol. Water dis- 
solves fifty per cent., and the solution has a yellowish-brown color. 
It contains mucilaginous, extractive, and astringent matter. The 
alcoholic solution or tincture is of a deep yellow color, and has a 
penetrating nauseous taste. The astringency of rhubarb depends 
on the presence of tannin and gallic acid. Its proximate prin- 
ciple, called rhubarbine, is of no practical value. 

Rhubarb has been successfully resorted to as a substitute for 
tobacco, and to cure a bad habit. It is decidedly preferable to 
the nasty weed in every aspect, and not at all likely to establish 
a habit half so injurious as that which it is employed to remedy. 
Some persons carry the root in their pockets to chew occasionally, 
for the purpose of getting rid of habitual costiveness. While it 
purges gently, it leaves the bowels in a better condition than is 
induced by neutral salts. Its astringency is the quality that 
compensates for the debility of the bowels consequent on the 
cathartic action. The tannin makes it really a tonic cathartic. 
From fifteen to thirty grains of good powder of rhubarb will purge, 
without griping or loss of tone of any part of the alimentary 
canal. A drop or two of oil of cinnamon, or a few grains of 
cloves or cinnamon powder, will cover the nauseous flavor of rhu- 
barb so that it can scarcely be perceived. The same end can be 

* The most common adulterations of rhubarb are the substitution of inferior 
sorts for finer kinds, especially when the drug is sold in powder. Then it is very 
difficult to detect the fraud, as the bright yellow characteristic of the best kinds 
may be imitated by mixture with some coloring matters. In respect of the solid 
root, those pieces should be preferred which are moderately heavy and compact, 
have a bright color, a fresh appearance when broken, with reddish, yellowish, 
and whitish veins intermixed, an aromatic odor, an astringent not mucilaginous 
taste, coloring the saliva yellow when chewed, and sometimes giving it a reddish- 
yellow. The fraud of filling worm-holes with a paste of rhubarb and mucilage 
and then rolling the pieces in fine rhubarb powder should be borne in mind, for 
it is very often practiced. Every lump of rhubarb should be broken and in- 
spected if there is reason for suspicion at all. — Adulteration of Medicines, 
page 191, 



716 DINNER PILLS. 

reached by the addition of calcined magnesia, though not so per- 
fectly. 

A very frequent addition to powdered rhubarb is calomel, and 
the combination is a very efficient and not disagreeable cathartic. 
It is also combined with the sulphate of magnesia, and occasion- 
ally with jalap and a very small portion of ipecacuanha. 

Rhubarb may be so administered as to prove a tonic chiefly, 
while it may gently act on the bowels. From three to five grains, 
taken daily or every other day, have produced these results. 

The dinner pill for dyspeptics contains rhubarb and carbonate 
of soda, and is usually taken an hour before dinner. The peri- 
staltic persuaders of former times were composed largely of rhu- 
barb. The peculiar name grew out of the tendency of the pills 
to promote peristaltic action and subdue constipation. They were 
made as follows : — 

I£. — Pulv. rhei, gi; 

Pulv. ipecac, grs. x ; 

01. carui, V(\ x ; 

Pulv. gum Arab. q. s. to make twenty pills. 

The dose, two or three pills taken at bedtime, operates on the 
bowels gently yet efficiently. 

The stomachic pills were prepared as follows : — 

R. — Pulv. rhei. gss; 
Pulv. ipecac. 
Sap. Castil. aa gi ; 
Muc. gum Arab. q. s. to make sixty pills. 

The dose of the pills was three or four twice a day. They 
give tone to the stomach and bowels, and operate gently. Hence 
they are useful to persons laboring under indigestion and cos- 
tiveness. 

The combination of calcined magnesia and rhubarb, hinted at 
above, is very useful in infantile diseases. The magnesia lessens 
the tendency of the rhubarb to gripe. It neutralizes the acid in 
the stomach and bowels, and so promotes the action of the rhu- 
barb. Adults troubled with flatulence and indigestion, and in- 
clined to be costive, are relieved by taking occasionally ten grains 
of rhubarb in powder, a teaspoonful of calcined magnesia, and 
five grains of powdered cinnamon or ginger, mixed with syrup 
of ginger. For persons laboring under piles, and who require 
a mild cathartic, rhubarb with magnesia will be found much bet- 
ter than more active cathartics. 

The article called rhubarb tea is often a very useful medicine. 
It is made by adding one or two drachms of the root to a pint 
of boiling water, and gently simmering for a few minutes. A 
teaspoonful of carb. soda is to be added to a wineglassful of the 
tea, for a dose. It acts gently on the bowels, and is a very plea- 



SYRUP OF RHUBARB. 717 

sant medicine. Rhubarb taken in this way speedily passes by the 
kidneys, and may be detected in the urine in ten minutes after 
the dose has been swallowed. This may be regarded as a quick 
passage ; and it is so, for it demands a longer time to make this 
manifestation when the powder is administered. If we apply a 
poultice of rhubarb to the abdomen of a young child, it will 
purge, but cannot be detected in the urine. If the powder be 
applied to an ulcerated surface, it can be found in the urine with- 
out difficulty. The inference has been made, and we think justly, 
that in the case of infantile purging as just named, the action is 
through the nerves, while in the last case it is evidently by ab- 
sorption. 

The infusion, tincture, compound tincture, spiced rhubarb, and 
syrup of rhubarb are employed in the practice of medicine, and 
are variously estimated by practitioners. To make a good infu- 
sion we give the following formula : — 

R. — Rad. rhei contus. gi; 

Rad. gentian contus. gss ; 
Pulv. caryoph, ^i ; 
Aq. bullient. Oi. 

Mix, and macerate for the space of two hours in a covered 
vessel, and strain. The dose is a wineglassful every hour until 
it purges. Some omit the gentian, or add only a scruple, and 
this is a matter of little moment. The tincture and compound 
tincture are alcoholic preparations, and are not necessary. The 
first may be made by digesting two ounces of the root in a pint 
of brandy, adding two drachms of fennel-seed. The other, 
which is pretty much the same, is made with the addition of nut- 
meg, cloves, mace, or cinnamon, to render the dose pleasant. The 
" rhubarb is made thus : — 



%. — Rad. rhei contus. 
Myrist. moschat. 
Muc. moschat. aa ^ij ; 
Aquae, ftrij. 

Mix, and simmer over a gentle fire for about an hour, and 
when cold, strain for use. Some add to this, which is a sort of 
infusion, a portion of brandy, in order to prevent it from spoil- 
ing. This is not necessary, as the aromatics will accomplish that 
end sufficiently well. The dose for a child two or three years 
old is a teaspoonful, repeated every hour or two until the alvine 
discharges regain their wonted color. 

The syrup is preferred by many because more readily taken 
by children. It is made thus : — 

Take of bruised rhubarb root, ^i ; 
Caraway seeds, ^ij ; 
Cardamom seeds, £i ; 
Raisins, stoned, ^ij ; 
Boiling water, Oi. 



718 SUMACH — CASTOR OIL. 

Macerate for the space of two hours, and then strain. Some 
boil the whole a few minutes before straining, though that is not 
necessary. To the clear liquor add two pounds of refined sugar 
and simmer over a slow fire until the syrup is formed. The dose 
is the same as for the spiced rhubarb, and is very useful in the 
summer bowel complaints of young subjects. It is generally 
best to give a few grains of calomel three or four hours prior to 
the use of the syrup, especially in cases of infantile diarrhoea. 
I know, from much experience, that the practice is safe and 
successful. 

Some practitioners make a decoction of rhubarb for bowel 
affections. They add magnesia and cinnamon with other aroma- 
tics, and form the fluid into a syrup when desirable. I am not 
aware that it possesses any superior advantages. 

The only preparation of rhubarb that remains to be noticed is 
one introduced by Mr. Hoblyn, of Middlesex Hospital. He di- 
rects good rhubarb root to be calcined in a covered crucible until 
it is quite black. It loses two-thirds of its weight by calcination, 
and is nearly tasteless. It is given in milk or water, in five or 
ten-grain doses. Mr. H. has given it for twenty years, in the 
diarrhoea attending pulmonary consumption. 

Rhus Toxicodendron. Rhus Radicans. Poison oak, or 
Sumach. — This vegetable is known all over our country as a 
poisonous weed. Some persons of peculiar susceptibility are 
readily injured by the mere exhalations from it, while others can 
handle it with impunity. I attended a young lady once whose 
features were almost obliterated by the swelling occasioned by 
this agency. She was cured by the use of a weak solution of 
corrosive sublimate, and free purgation. 

The internal use of the leaves has been highly praised as a 
remedy for palsies of the lower limbs, for herpetic affections, 
&c. Sometimes the powdered leaf, in the dose of half a grain 
three times a day, has been employed. Dr. Alderson thus ex- 
hibited the rhus, and also in shape of infusion, made by digesting 
six grains in eight ounces of boiling water. The dose was a 
tablespoonful three times a day, and the effect was to induce 
convulsive twitches of the palsied parts. Dr. Fresnoi made use 
of a strong infusion, drank freely for six weeks, which acted as 
a diuretic and diaphoretic. He tells us that he cured very obsti- 
nate herpetic disease in this way. (See Medical Commentaries.) 

Ricini Oleum. Castor oil. Raima Christi. — The plant 
yielding the seeds or beans that furnish this valuable oil is a 
native of the West Indies, South America, Africa, and Asia. It 
flourishes in North America, and is very extensively cultivated 
in the States of Illinois, Ohio, Indiana, &c, and thousands of 
barrels of the oil are manufactured there. When the plant finds 



MODES OF TAKING CASTOK OIL. 719 

a place in the garden, it is not easy to expel it. The seeds blown 
about by the winds are sufficiently deposited in the soil to insure 
a crop of plants, however undesirable they may be. The tree, 
for such it often is, has quite an ornamental appearance, and a 
few shoots are allowed to remain in a garden as a. pretty variety 
of vegetation. The ripe seeds or beans plucked by children and 
eaten, have done a good deal of mischief by the severity of their 
action on the stomach and bowels. A lady, the wife of a most 
respectable physician, was nearly destroyed by the imprudent 
eating of less than a dozen of the seeds as she passed through a 
garden where the plant attracted her notice. There would seem 
to be a peculiar acrid property in the seeds when thus taken ; they 
not only vomit and purge, but leave the system in a very pros- 
trated condition. This acrid quality doubtless resides in the hull 
or cortical part of the seeds, and was formerly combined with 
all the castor oil in use. The process of making the oil was by 
the ebullition of the whole seed, and hence the peculiar drastic 
quality of the West India oil employed in this country forty 
years ago. Hence the dark-brown color of that oil, and its fre- 
quent rancid quality, which made it so objectionable. 

The cold-drawn or expressed oil is a very different article. 
The hulls being seperated entirely by a proper process, the ker- 
nel, which consists almost entirely of condensed oil, is submitted to 
pressure, and the operation is effected without heat. Hence the 
propriety of the terms expressed and cold-drawn oil. As the 
entire product is oleaginous, without any of the coloring matter 
of the brown hull of the seed, the oil is fitly styled pale, and 
hence we see it sometimes nearly colorless. It has no taste save 
that of the pure oil, when prepared with a due amount of care. 

Castor oil is a viscid, fixed oil ; and in cold weather the vis- 
cidity seems to be an objection to its medicinal use internally. 
The difficulty is speedily removed by heating gently for a few 
minutes before its exhibition. It thus assumes the fluidity of 
the most temperate season. 

Various expedients are in use to facilitate the taking of this 
medicine ; and yet I prefer its exhibition alone, if there be no 
real objection. Dr. Wansborough, of Chelsea, suggests the fol- 
lowing : — Wet the inside of a wineglass, and particularly the edge. 
To a teaspoonful or two of brandy add five or six drops of lemon- 
juice and half an ounce of cold water. On this, and in the cen- 
tre, pour the requisite quantity of castor oil ; direct the patient 
to open the mouth wide, and throw the dose promptly down the 
throat. The flavor of the spirit and acid remain on the tongue, 
while the oil is not tasted. (See Braithwaite, part xiii.) 

In the same number of the journal just referred to is a sug- 
gestion of M. Righini, copied from the Journal de Cliimie Medi- 



720 USES OF CASTOR OIL. 

cede. He directs the oil to be mixed with about as much muci- 
lage of gum Arabic, to which he adds the juice of a sweet 
orange, free of the seeds. The whole, well mixed, should be 
swallowed promptly. 

Some persons prefer to take the oil with strong coffee, or 
wine, or brandy, or essence of mint, or molasses, and not a few 
prefer what is commonly called the castor oil mixture, made 
thus : — 

R.— 01. ricini, ^ij ; 

P. g. Arab. 

Sacch. alb. aa ijij ; 

Aquae cinnam. Jiv. 
Mix. 

When desirable, we may add a half-drachm of calomel to the 
above, and then it is important to direct that the bottle be well 
shaken prior to the administration of the close, because the calo- 
mel falls to the bottom speedily. The adult dose of the mixture 
is a tablespoonful every hour until purgation is effected. 

M. Parola has suggested some novel preparations of castor 
oil that may be worthy of notice, as they appear to be the result 
of a good deal of experimental research. He affirms that the 
purgative action of the ethereal and alcoholic tinctures of the 
seeds or beans is more powerful than that of the expressed oil, 
while those tinctures are not more irritant than the oil ; that 
they retain their properties unaltered for a very long time in 
any climate or season. These tinctures do not prove emetic, and 
very seldom even sicken the stomach. 

Castor oil alone will not always operate as speedily as when 
ten drops of laudanum are added. This may sound like a con- 
tradiction or paradox, yet it is not so. There is often an un- 
favorable state of spasm in the bowels, which would be augmented 
by the oil, simple and mild as it is. A few drops of laudanum 
will correct that state of the canal, and prepare it for the right 
action of the oil in due season. We have made too many trials 
of this combination to have a doubt on the subject. 

It is proper to say that by some unappreciated process in the 
bowels castor oil is changed into fatty masses, not unlike those 
formed by the action of nitric acid upon it out of the body. 
These round, fatty masses often pass away in the fecal discharges, 
though they have been found in quantities after death. 

The external uses of castor oil are sometimes important. In 
India it has been for a long while employed as a dressing for ring- 
worm %xA various cutaneous affections; and, in fact, its use was 
almost wholly for external purposes. We use it in this country 
for the same ends, and especially for the cure of itch. It is sup- 
posed to operate like all oily matters in the case of itch, by pre- 



USES OF CASTOR OIL. 721 

venting the insect which induces that disease from performing the 
functions of life ; in other words, the insect is destroyed. The 
oil has also been applied to burns and scalds, and to parts labor- 
ing under erysipelatous inflammation. A thick coating repeated 
twice a day is supposed to act by excluding the irritant qualities 
of the external air. 

But the oil is most extensively employed as a cathartic. This 
property resides in every part of the plant, and in Hindostan the 
bruised bark made into balls with tobacco leaves is given to horses 
for the cure of gripes. 

The almost universal testimony of the profession is in favor of 
the mild quality of the oil as a cathartic, and hence its supposed 
adaptation to females immediately after delivery. The British 
Flora Medica, in its notice of the mild action of castor oil, speaks 
of its peculiar fitness for young infants, in whom it also operates 
as an anodyne. The latter result, however, may be a sequel 
merely of the previous evacuation of the bowels and the removal 
of offending matters. 

The Montreal Medical Journal for November, 1846, speaks in 
high praise of castor oil as a remedy for disease of the mucous 
membranes, and especially for infantile diarrhoea. For a child 
of from two to six months old, it directs as follows : — From a 
drachm to a drachm and a half of the oil, the yolk of an egg, 
and an ounce of fennel-seed water are to be made into an emul- 
sion by due admixture. Give a teaspoonful three times a day. 
The color of the discharges is soon changed for the better, and 
all the symptoms mitigated. 

Colica pictonum has sometimes been subdued by the persever- 
ing use of the oil, associated with frequent injections and the warm 
bath. It is sometimes improved for this end by the addition of a 
drachm of spirits of turpentine to each dose of the oil. 

Habitual costiveness may generally be removed by the follow- 
ing plan : A tablespoonful, or two if necessary, should be taken 
so as to empty the bowels. On the next day half a teaspoonful 
less, and on each subsequent day a like reduction, until the dose 
is less than a teaspoonful, which will act sufficiently. Thus the 
difficulty has been obviated in many instances. The principle is 
a very obvious one, and needs no comment. 

In the treatment of dysentery, some practitioners rely on the 
use of castor oil more than on any other medicine. After bleed- 
ing and a dose or two of calomel and ipecacuanha, castor oil will 
frequently complete the cure. The tormina of dysentery may 
sometimes be speedily allayed by an injection of an ounce of 
castor oil, two ounces of warm water, and thirty drops of lauda- 
num, and this may be repeated two or three times in twenty-four 
hours. 



722 ROSE-WATER — ROUTLNISM. 

An individual who has made a fortune bj quack pills affirms 
that his famous cathartic pill contains ricinine, which, he says, is 
the active part of castor oil in a very concentrated form. 

Rose-Water. — A pleasant, fragrant article, obtained by dis- 
tillation of rose leaves. It forms a good vehicle for the exhibi- 
tion of various medicines, and is preferable to water in preparing 
eye-washes, after depletion has reduced the inflammation to the 
subacute form. The compound infusion of roses is made thus : 
Take of red-rose leaves, half an ounce ; boiling water, two pints 
and a half; dilute sulphuric acid, three drachms; sugar, an 
ounce and a half. Pour the water on the leaves in a glass vessel, 
add the acid, and macerate for six hours. Strain, and add the 
sugar. 

Rosmarinus Officinalis. Rosemary. The leaves. — It is 
not our intention to consume much time with this article. We 
do not regard it precisely as some do, who appropriate a large 
space for its consideration. That it has something like emmena- 
gogue qualities seems to be pretty generally conceded. Our 
chief design, however, is to apprise those of the profession who 
are not aware of the fact, that the oil of rosemary and a strong 
tea of the leaves are among the numerous devices in all large 
cities for inducing abortion. Whether the action is primarily or 
secondarily on the uterine organs, we do not propose to inquire. 
It is quite certain that profuse flooding and abortion have resulted 
from the exhibition of the preparations named. (See London 
Lancet, February, 1843.) 

Routinism. — We mean by this term to convey the idea of a 
kind of habit in medical men that leads to the use of the same 
medicine for all purposes. There are physicians who carry with 
them their boxes of pills to the number of three or four, and these 
are invariably administered, no matter what the disease may be. 
The pills may be well compounded of articles in due proportion, 
and may be well adapted to certain ends. But habit is almost 
invincible, and because the pills are really good the doctor feels 
at liberty to dispense them on all occasions. The practice is 
radically and entirely wrong ; not a whit more philosophical than 
that of the Dutch root-quack, who filled his patients' vials out of 
a common huge jug. It is no valid argument in favor of either 
that many of the sick get well, because we are well assured that 
nature comes happily to the rescue, and that the patient recovers 
in spite of the folly of the physician. 

The true practice of physic is based on a right adaptation of 
curative means to each case, just as though it were the only one 
to be treated. No two patients present the same precise features 
in all respects, and hence the need of discrimination in the first 
place, and of corresponding prescription afterward. It cannot 



MADDER — BLACKBERRY. 723 

harm the doctor nor his patients to have his quiver full of arrows 
at all times, to be ready for any emergency that may occur. But 
it must operate most ruinously on the human constitution, when, 
to cure its ills, the bow is drawn at a venture, aimed nowhere 
and directed by no sort of principle. 

Rubia Tinctorum. The root of dyers' madder. — The root 
is grown largely in France and Holland, and is of a reddish hue 
externally, of the thickness of a quill, and having numerous 
branches. It has little smell, and a slightly-astringent taste. 
Formerly it was regarded as tonic, astringent, and emmenagogue. 
The use of it for a short time colors the bones. The dose is from 
half a drachm to two drachms every three or four hours. 

Rubus Trivialis. Dewberry. 

Rubus Villosus. Blackberry. — As these fruits are confess- 
edly very much alike, our remarks will apply alike to both. 
The estimate of these articles is very various ; and yet there are 
practitioners who would regard a book like the present as quite 
defective if it failed to give them a passing notice. It is well 
known to all persons that no ripe fruits are eaten with more 
general impunity ; in fact, their salutary quality is proverbial 
everywhere. 

A decoction of the roots, and various syrups and jams and cor- 
dials, are manufactured by families all over the country, and 
great reliance is placed on them for the treatment of various 
bowel affections. We feel so strongly tempted to narrate an 
anecdote here that we must be gratified. In a medical school 
(which shall be nameless, albeit it has a very potent cognomen) 
of this country, two professors happened to hit on the same day 
for the notice of the dewberry and blackberry roots. Their lec- 
tures were only an hour or two apart, and of course the impres- 
sion was the more striking. Said one, " I have the authority of 

Dr. (a very distinguished teacher and physician) for saying 

to you, gentlemen, that no reliance can be placed on the decoc- 
tion of these roots in the management of disorders of the bowels. 
It is utterly worthless." The other professor, who was teaching 
Materia Medica, averred, on the authority of the same distin- 
guished gentleman, who happened to be a near relative, " That 
the decoction of the roots and the syrup of the fruits were most 
excellent medicines, and had saved the lives of many children who 
were suffering from the prevalent bowel disease of hot weather." 
The story is a fair illustration of an old adage. 

I like the preparations named because they are more accessible 
than foreign articles, and answer in many cases quite as well as 
more expensive prescriptions. The decoction or tea is prepared 
without any specific rule. Boiling water soon extracts all the 
astringency, and a hot infusion will accomplish the same end. 



724 DOCK — RUE. 

The dose is not limited ; as much and as frequently as it can be 
taken without annoying the stomach, is a good rule. 

The syrup and cordial are so well known to all families that 
we do not feel disposed to enter into details. 

Rumex. The Dock. — Our country furnishes dock roots in 
considerable variety, and they are held in high estimation by the 
common people. The acetosa variety is our common sorrel, some- 
times called sour dock. The acutus is the sharp-pointed wild 
dock ; the decoction of the root has been useful in leprous and 
impetiginous affections. The alpicus or monk's rhubarb is laxa- 
tive. The aquaticus hritt aniens is the yellow-rooted dock, called 
also yellow dock root. Its leaves have a good deal of acidity, and 
are laxative. The root is quite astringent, and has been much 
employed, externally and internally, for the cure of some cuta- 
neous diseases, as lepra, lichen, scurvy, &c The powdered root 
is also used as a dentifrice. The dose of the dried root, made 
into a decoction, is about one drachm. Two ounces of the root 
in a pint of boiling water, digested for two or three hours, will 
make the decoction of about the proper strength. 

The sanguinec{ variety gives what is called bloody dock, which, 
on account of its astringency, has been used in diarrhoea. There 
are other varieties of rumex, but it is not necessary to cite them. 

Ruspixi's Styptic. — It is by no means certain that we know 
the precise composition of this article. It is pretty generally 
agreed, however, that it consists of a strong solution of tannic 
acid in alcohol, modified by the addition of rose-water. 

Ruta Gtiaveolens. Garden Rue. — This is a bitter vegeta- 
ble, found in nearly all our gardens, and employed in the form of 
tea, or decoction or infusion, as a means of relieving the pain 
attending the catamenial flow. It is held to be an emmenagogue. 
The juice of the fresh leaf in large quantities is a narcotico-acrid 
poison, and capable of producing abortion. "A girl in the 
fourth month of pregnancy," says Dr. Helie, in the Annates 
a" Hygiene, "took for several days a strong dose of the fresh 
juice expressed from the leaves. Yomiting, severe colic, great 
prostration, tendency to syncope, somnolency, delirium, and 
coldness of surface came on. There was also an inflammatory 
swelling of the tongue, attended with profuse salivation. The 
expulsion of the foetus did not happen until the sixth day after 
swallowing the poison." 

Several other cases are given, very much of the same nature, 

proving conclusively the deleterious influence of rue. Dr. H 

says that its action in lessening the force and frequency of 
the heart's movements is as evident as that of digitalis. He 
has known the pulse to sink, in a short time, to thirty in a 
minute. 



SAVINE. 725 

In one case of attempt to induce abortion, and which succeeded, 

Dr. H arrested the vomiting by withdrawing the drink the 

female was using, not then knowing that it was a decoction of 
rue, and confining her to barley-water. This would seem to in- 
dicate that the poisonous influence is arrested without serious 
difficulty. 

Although the use of rue, as here stated, has been very com- 
mon in France, it is not unfrequently made subservient to the 
same end in this country. 

Sabine Folia. Juniperm Sabina. Savine. The leaves. — 
This is an evergreen, and grows in various parts of the United 
States. It is cultivated as an ornamental shrub, rather for its 
perpetual verdure and fragrance than for a truly valuable quality 
not medicinal. It has a very strong, peculiar smell, a bitter, 
acrid, pungent, heating taste. The active properties reside in an 
essential oil obtained by distillation. This, as well as the hot 
infusion of the leaves, is regarded a very efficient uterine stimu- 
lant, resembling in its operation the Spanish fly. When incau- 
tiously employed, or given largely by design, it acts with great 
violence and destroys life. Such are its ultimate consequences 
when administered to effect abortion, an end for which it is too 
frequently employed. As these cases have become matters of 
notoriety, it is well to remember that on opening a body after 
death from this agent, the peculiar savine smell is very obvious, 
and sometimes the green tinge of the decoction is visible in the 
intestines and stomach. 

The London Medical G-azette, 1845, has the case of a pregnant 
woman, near full term, who was poisoned by savine. The mother 
and foetus were both destroyed. 

Savine is one of the articles usually called emmenagogue, and 
it does appear to exert a decided agency on the uterine organs. 
Its activity and energy require that it be administered by judicious 
men, and not by every ignoramus who may choose to prescribe it. 
In amenorrhoea, with a very languid circulation and no fever, it 
is frequently an efficacious medicine. 

A writer in the Revue Medicale recommends savine very highly 
in what he calls passive uterine hemorrhage of long standing, 
where the blood has lost its red color, the serosity being in ex- 
cess and a kind of anaemic habit established. The formula ad- 
vised is thus : — 

R. — Puly. sabinee, ^iij ; 
Extract sabinse, gij ; 
01. sabinse, ^i. 

Mix, and divide into pills weighing three grains each, and give two for a dose 
three times a day. 

Savine has also been successfully administered in menorrhagia 



726 SACHETS — SAGO. 

of the atonic form. Several cases are cited in which doses of 
fifteen or twenty grains, thrice a day, have been efficacious. 
(See American Journal of Medical Sciences, October, 1844.) 
We should have remarked before, that the emmenagogue property 
of savine was considered as well established several centuries ago, 
and great reliance was then placed on its powers, duly regulated. 
(See 3£edico-Chirurgical Review, 1844.) 

But savine has also been resorted to as an anthelmintic. The 
dose of the fine powder for children varied from five to ten grains, 
given in syrup, three times a day ; or from two to five drops of 
the oil on sugar. It is probable that the successful action of tur- 
pentine as a vermifuge, led to a similar employment of the savine. 
1 have never tried it for this purpose. 

The expressed juice of the mature green leaf, a little diluted, 
has been prized as an application to the scalp for the cure of 
tinea capitis, and also for the relief of scabies. It is probable 
the effect is due to counter-irritation. 

The ointment or cerate of savine is a good article to maintain 
and augment the discharge from raw or blistered surfaces. The 
powder of the leaf is also applied to unhealthy ulcers, to induce 
a more vigorous action. To prepare this cerate a pound of the 
bruised leaves and half a pound of yellow wax are mixed with 
two pounds of lard. The mixture should be simmered over red- 
hot coals and then strained through a linen cloth. It has a yel- 
lowish-green color, and a strong smell of the plant. 

The extract named can be prepared as other extracts are, by 
making a very strong decoction of the plant and evaporating 
the clear liquor to a proper consistence. 

Sachets, or little bags, long ago recommended by Leuret, and 
quite too much neglected at the present time. They may be 
made of linen or other suitable material, and should be so large 
as, when filled and well moistened, to impact the vagina. The 
contents may consist of fine powder of best galls, alum, sulphate 
of quinine, rhatany, kino, &c. &c. Each sachet should have a 
tape well secured to it so as to allow of easy removal. After 
being filled with some or all of the above articles, dip it in port 
wine or claret, and, after soaking, squeeze gently, and before 
passing it into the vagina coat the surface with sweet oil. 

These little contrivances give tone to the vagina walls and 
help to keep the womb in its proper position. They should be 
changed every five or six hours, and may be worn for weeks, 
being decidedly better than any of the solid pessaries in use. 

Sago. — The pith of the cycas circinalis yields this well-known 
article of diet. It is a starchy farina, and the word is sometimes 
written sagu. As we generally purchase it in the shops it con- 
tains more or less dirt, which should be separated by washing 



salix. 727 

with clean cold water. A tablespoonful or two of good sago 
boiled in a pint of water will make a sort of jelly which can be 
rendered very palatable by the addition of sugar. Some prefer 
a little lemon-juice or syrup of ginger. It is an emollient, sooth- 
ing, and sufficiently nutritive diet for convalescents. 

Saint John Long's Celebrated Ointment. — Take the yolk 
of an egg ; oil of turpentine, §iss ; strong acetic acid, Si ; pure 
water, giij. Rub the yolk, water, and acid well together, and 
then add the turpentine, shaking frequently. The counter-irri- 
tant action of this ointment is obtained by using a sponge to coat 
the parts. The effects vary with the force of the friction and 
the length of time the application is continued. 

Salep. Salep Root. — A farinaceous substance extracted from 
the orchis morio, and imported from Turkey. It is employed as 
an article of diet, and can be prepared in the manner pointed 
out for sago. 

Salix. The Willow. — The aborigines of our country have 
been familiar with the medicinal properties of the various kinds 
of willow, as well as with the uses of the branches for purposes 
of domestic economy, from the earliest periods of their history. 
Subject as they were to ague and fever, they were obliged to re- 
sort to the best means in their possession ; and hence the willow 
was employed in the form of strong decoction. Although infe- 
rior to Peruvian bark, it is possessed of astringent and tonic 
qualities that render it a comparatively valuable article. 

The infusion, decoction, and tincture have been employed. 
The first are made as strong as possible, and are really saturated 
solutions. Two or three ounces should be boiled in a quart of 
water for half an hour and strained. Take of the strained liquor, 
six ounces ; bruised orange peel, two drachms ; compound infu- 
sion of roses, three drachms. Mix, and take it in four portions 
in the course of the day. The dose of the powdered bark of the 
willow varies from thirty to ninety grains. 

The variety of willow called salix caproea is the one from which 
the vegetable alkaloid salicine is obtained. It is a very neat and 
useful preparation, and much employed as a substitute for sul- 
phate of quinine, though decidedly inferior to it. The dose is 
from five to twenty grains. To determine whether salicine is 
present in a sample of willow bark, a drachm is boiled in four 
ounces of pure water. A drachm of litharge is added to the in- 
fusion so made, and the filtered liquor is acted on by sulphureted 
hydrogen gas to precipitate the lead. The liquid is then evapo- 
rated to one ounce. If the addition of sulphuric acid gives a 
bright purple-red, salicine is there in sufficient quantity to justify 
the requisite labor to procure it. The process just named, prior 
to adding the sulphureted hydrogen gas and sulphuric acid, is 



728 USES OF ELDER. 

the one employed to get the salicine. The litharge is added to 
the decoction to detach the acid matter from the salicine, which 
latter falls as a precipitate. The mixture, after digestion for 
twenty hours in a sand-bath, is filtered, and the clear liquor 
evaporated to the consistence of syrup. As it cools crystals of 
salicine appear, which must be redissolved in pure water and 
evaporated as before. 

It is proper to say, that the surgeons of the United States 
army were instructed by the surgeon-general to test the anti- 
periodic powers of salicine on a broad scale, to see what propor- 
tion it bore to the sulphate of quinine ; and the result was by no 
means favorable. Still, there are practitioners who esteem sali- 
cine very highly. It may be combined with sulphate of quinine 
and piperine advantageously in cases that do not yield very 
promptly to the salt of quinine alone. 

Sambucus Nigra. Black Elder. — We do not name this ar- 
ticle because of any very great importance attached to it by the 
profession generally. The plant is common in every region al- 
most, where it is recognized by the blossoms, and subsequently 
by the large quantities of the berries, which are gathered by chil- 
dren for the purpose of eating. An infusion or tea of the blos- 
soms has long been in use for various purposes, as well as an 
ointment of the leaves and blossoms. The late Stephen Girard 
was so very partial to the elder ointment that he made it with 
his own hands, and kept it in his house for distribution among 
his friends who happened to be burnt or scalded. It is a very 
pleasant application, and should be renewed twice a day. Some 
persons think it a valuable application to allay the itching and 
heat of erysipelas. 

We are led to notice the elder-plant a little more particularly 
because of recent encomiums passed on the juice of the fresh root 
as a remedy for dropsy. Some of the old writers speak highly of 
the diuretic qualities of the juice of the inner bark, while very few 
hints can be found in any of our books respecting the medicinal 
properties of the root. Pereira speaks well of the hydragogue 
action of a decoction of the inner bark as well suited to dropsy, 
and directs it to be made by boiling an ounce of the bark in a 
quart of water down to a pint, which is to be exhibited in doses 
of four ounces. Simon, in the Annal. der Pharm., vol. xxxi. 
p. 362, says: — "The active principle of the inner bark of the 
root is a soft resin, which may be obtained by exhausting the 
powdered bark with alcohol, filtering and evaporating to the 
consistence of syrup, then adding ether to dissolve the active 
matter, which is to be evaporated to the consistence of an ex- 
tract. Of this, twenty grains induce vomiting and purging." 

The editors of the United States Dispensatory tell us that 



SANGUINARIA CANADENSIS. 729 

"the juice of the root has been employed as a diuretic in 
dropsy." 

In the Repertoire de Pharmacie of 1849, edited by Bou- 
chardat, we find the following statements as the result of investi- 
gations made by M. Rene Vanoye : — The fresh juice of elder-root 
may be administered in all serous accumulations and infiltrations 
requiring the use of drastics. It generally acts with greater 
energy and rapidity than the most active purgatives. There is 
no advantage in combining it with drastics or diuretics, its action 
never being more decided than when given alone. If it induce 
vomiting, it should be suspended for a few days, but not on this 
account abandoned. From four to six ounces, given in teaspoon 
doses, will generally be found sufficient. It often cures dropsies 
which have refused to yield to other means, and is not a danger- 
ous medicine. 

The second bark of the black elder has long been known as 
possessing emeto-cathartic and hydragogue qualities, and hence 
suited to dropsical affections ; but M. Bogetti has employed it 
successfully in five cases of epilepsy. His directions are these : — 
Take branches of the elder one or two years old, removing the 
gray or outer coat, and scraping off the second bark ; on this 
latter, to the amount of two ounces pour five ounces of hot or 
cold water, and set aside for forty-eight hours ; then strain or 
filter, and take a mouthful of it every quarter of an hour when 
the fit is anticipated. The patient should abstain from food at 
the time. Let this treatment be resumed every six or eight days. 
We would have been better pleased if the ages of the patients 
had been given. — Braithivaite, part xxx. p. 38. 

Sanguinaria Canadensis. Puccoon. Blood-root. — This is 
a very abundant plant in various portions of the United States. 
It is one of the earliest spring plants in the West, and is seen on 
a southern hillside very soon after the frost quits the ground. 
The root, taken recently from the ground, is seldom as large as 
the thumb, and frequently less than the little finger. If broken, 
as it may easily be, it exhibits a blood-red fracture, and hence 
one of its names. This marked color very early led to the be- 
lief that it must be a capital remedy for discharges of blood of 
every grade. The taste is decidedly acrid, and after chewing it 
but a moment, the sense of acrimony remains a good while. 

Sanguinaria is held to be tonic, stimulant, emetic, expectorant, 
narcotic, and feebly astringent. The late Professor Barton 
valued it chiefly as an emetic, and therefore believed it to be 
suited to various forms of sore throats, as cynanche trachealis, 
cynanche maligna, &c. From fifteen to thirty grains of the 
powdered root act as an emetic, and a smaller dose nauseates. It 
may be taken in sweetened water or syrup. In dyspnoea that 

47 



730 SANGUINARIA CANADENSIS. 

will not admit of bleeding, from thirty to sixty drops of the 
tincture, or a teaspoonful of the infusion, given every hour, affords 
sensible relief. The design of the medicine is to nauseate or 
vomit ; and unless the dose named induce one of these effects, it 
must be enlarged. The same doses, carried to the nauseant or 
vomiting point, have been equally beneficial in asthma and severe 
colds. The late Professor Eberle was very partial to the tincture 
for the relief of cough attending pulmonary consumption. The 
dose was a teaspoonful given every two or three hours until it 
sickened the stomach. I have derived obvious benefit from a mix- 
ture of this tincture, and the tincture of lobelia, a half-teaspoon of 
each several times a day, and increasing the proportions if 
necessary. 

Dr. Horace Green, of New York, has published some high en- 
comiums on the good qualities of the blood-root, of which he pre- 
fers a saturated tincture. In torpor of the bowels, dependent on 
hepatic derangement, the following has been quite efficient : — 

R. — Tinct. sang. Canad. sat. 
Tinct. aloes, comp. aa ^i. 

Mix. Give thirty to sixty drops twice or thrice daily. It improves the diges- 
tive organs and accelerates peristaltic action. 

The favorite mixture for bronchial or pulmonary irritation and 
severe cough is as follows : — 

R. — Tinct, sang. Can. sat. gi; 
Opii, m ; 
Vin. ipecac, ^vi; 
Syr. tolu. gij ; 
Mix. Dose, thirty to sixty drops four to six times a day. 

The following laxative pill is also highly commended : — 

R. — Pulv. sang. Canad. 
Rhei. opt. aa gi ; 
Sapon. ^ij ; 
Aquae, q. s. 

To make pill mass for thirty-two pills, of which take one night and morning. 
— Amer. Drugg. Gaz., 1857. 

Some of the western practitioners employ a syrup made of 
the strong infusion as a remedy for cholera infantum ; and al- 
though I have never employed it, I am disposed to regard it with 
favor. It has also been tried in the management of intermittents, 
in consequence of its emetic and subsequent diaphoretic ac- 
tion. The tonic power is said to be developed by the use of 
three-grain doses daily ; but I have no satisfactory evidence in 
this relation. 

The late Professor Nathan Smith had long been in the habit of 
administering blood-root, and was very partial to it. He pre- 
ferred the simple infusion to any other preparation of the plant. 



SANGUINAMA POISONOUS — SOAP. 731 

The powder was regarded by him as too harsh, and the tincture 
less efficient than the infusion. His opinion was probably 
correct. 

The infusion is readily made by digesting an ounce of the 
bruised root in a pint of boiling water. A teaspoonful is a suit- 
able dose, and should be repeated every two or three hours to 
induce nausea. Two ounces of the root and a pint of brandy 
form a tincture the dose of which is from thirty to sixty drops. 

In addition to the infusion just named, there is another formed 
by saturating strong vinegar with the root. This has been ap- 
plied to common tetter and ringworm, and also for the cure of 
scald head. A very pretty cerate is formed of the fine powder 
of the root well rubbed with fresh lard or simple cerate, in the 
proportion of a drachm to an ounce. This is regarded in some 
localities as a very superior heeding cerate, and is so employed. 

We have to add, in conclusion, the proof of poisonous quality 
as furnished in the New York Journal of Commerce, in 1841. 
Four persons, engaged to clean and whitewash the apothecary 
shop of Bellevue Hospital, found a demijohn which they sup- 
posed contained brandy or spirit of some sort, of which they 
drank very freely. They were seized with severe racking and 
burning pains of the stomach and bowels, intense thirst, &c, and 
all died. They feared to apprise the physician of the house 
until it was too late. 

Some have conjectured that the brandy killed the men ; but it 
is probable they were not novices in the use of that article, and 
therefore not likely to be seriously injured by it. As it was a 
strong tincture of blood-root, the result must be referred to the 
poisonous agency of the root in a very enlarged dose. 

Sapo. Soap. — Hard soap is made with olive oil and soda. 
Castile soap, one of the varieties of hard soap, is employed to 
wash diseased parts, and so to fit them for the application of 
lotions, liniments, cerates, and absorbent powders. 

Soft soap, made in this country by boiling any sort of grease 
or fat with the strong ley of wood-ashes, is usually of the con- 
sistence of honey, but often is more solid. 

Any form of soap serves an important purpose by neutralizing 
acids in the stomach when likely to exert a poisonous influence. 
The potash in the soap is the antidote that meets the case. The 
soap should be so diluted that it may be swallowed with ease, 
and also thrown up the rectum. 

Habitual costiveness is more certainly subdued by rhubarb, 
aloes, or colocynth, if well incorporated with soap, which 
serves to make a better pill mass at the same time. The oily 
matter of the soap, it is believed, tends to bring this desirable 
result. 



732 SARSAPARILLA — SCABIOUS. 

Under the article potash, we alluded to the use of soap in the 
treatment of burns and scalds, and need not repeat. 

Soap liniment is often a very good application to bruised and 
painful parts. It is made by dissolving an ounce of camphor in 
sixteen ounces of spirit of rosemary, adding three ounces of 
soap, and macerating with a gentle heat until the whole is dis- 
solved. 

Steer s opodeldoc is a little different from the soap liniment. 
It is made thus : — 

' R — Sapon. alb. ^xiv ; 
Alcohol, Rov; 
Aquae, ibss ; 
01. lavend. 
" rorismar. aa giij ; 
" origan, gij ; 
Gum camphor, 25 iv. 

Mix, and digest for the space of ten days. The whole mass 
becomes like a jelly, but is readily liquefied even in the palm of 
the hand. It is an excellent external application to parts bruised 
or very painful. 

Soap is one of our best articles for making suppositories. It 
should be of the consistence of the brown soap usually employed 
in washing clothes,- and is then easily moulded into a proper 
shape. A piece about two or three inches long, and from half an 
inch to an inch in diametei , made entirely circular, will serve the 
purpose. An advantage of soap is the readiness with which we 
can blend opium or cathartic medicine with it. 

Sarsaparilla Smilax. — We have large quantities of sarsa- 
parilla in this country, and much larger quantities are imported ; 
and the article is variously estimated by regular practitioners as 
well as by regular quacks. It is employed in decoction, syrup, 
compound syrup, extract, &c, and is recommended in all our 
newspapers as a panacea. If the millionth part of what is said 
about its efficacy were true, it would seem that men and women 
should no longer die, or, at all events, cease to suffer. I have 
surveyed this subject with a good deal of care, from the days of 
Swaim's glory with professorial endorsements down to the penny 
newspaper puffs of old Jacob Townsend's syrup, and the conclusion 
of the whole matter is, that sarsaparilla is a most worthless arti- 
cle, regarded per se. It may do very well for the vehicle of 
other substances, and may, therefore, innocently enough help to 
make up a diet drink ; but that is quite as far as I can venture 
in its commendation. For me to say another word in praise of 
it would be a breach of truth. 

Scabious. Erigeron Philadelphicum. Philadelphia 'Flea- 
bane. — The plant commonly called fleabane and scabious grows 
plentifully in the vicinity of Philadelphia, and is so well known 



SCAMMONY. 733 

as not to need a description. The whole herb is used, and should 
be collected while the plants are in flower. The odor of the plant 
is aromatic, its taste bitter, and all its properties are readily im- 
parted to boiling water. My chief reason for introducing it here, 
is that it was a favorite with the late Professor Wistar and Dr. 
Joseph Parrish, who esteemed it as a good diuretic, and superior 
to some others, because inoffensive to the stomach. The gentle- 
men named, and others under their influence, employed the plant 
in gravel and other diseases of the kidneys, and in various 
dropsies in gouty persons. 

The infusion or decoction, made by adding an ounce of the 
plant to a pint of boiling water, was the favorite mode of ad- 
ministration, and this quantity was consumed in twenty-four 
hours. 

From all that I could learn respecting this article as exhibited 
by the distinguished physicians named, it served chiefly as a sub- 
stitute for other diuretics, and was therefore alternated with them. 
Now and then a dropsical patient appeared to be cured by the 
persistent use of the scabious. 

Scammony. Convolvulus Scammonia. Critm Resin. — Smyrna, 
Aleppo, Montpelier, and other places furnish large quantities of 
scammony. The root of the plant, when cut, yields a milky 
juice, which concretes, changes color, and assumes the form of 
commercial scammony. That which comes from Aleppo is gene- 
rally regarded the best, very probably because it is the most 
costly. The external aspect is of a dark gray color, and even 
darker, so as to be nearly black. Within, it is of a gray, or 
greenish-brown, and of a softer texture than the outer portion 
exhibits. The fine powder of the best scammony is of a light 
green, or a grayish-green color. The odor of the gum resin is 
not unlike that of some kinds of cheese. Trituration of scam- 
mony with water makes a milky-looking mixture. 

Scammony is called a drastic cathartic, and, if given alone, is 
very apt to gripe. A few grains of an aromatic added to the 
usual dose of scammony lessen the griping tendency, and often 
prevent it entirely. The combination with calomel and jalap has 
a similar effect. The ancient pulvis basilicus, called also the 
royal or noble powder, was a compound of equal parts of scam- 
mony, calomel, and jalap, and operated not unpleasantly. 

The dose of scammony is from five to fifteen grains, and of 
this it is said the resin is the only medicinal part. Proof spirit 
readily dissolves scammony, but the solution is of no value, ex- 
cepting as a lotion to cutaneous affections of the herpetic kind. 

Scammony may be given in pill, in powder with syrup, or in 
the form of emulsion. 

In the times of Dr. Friend, fifteen grains of calomel, ten of 



734 USES OF SQUILL. 

jalap, and five of scammony were given in one dose to young 
females of fifteen, as a means of forcing the catamenial discharge. 
(See fiend's JEmmenalogia.) 

Scilla Maritima. Sea Onion. Squill-root. — This is a bulb- 
ous root, very much like the common onion. It is brought from 
the Levant, packed in wet sand in order to be kept in a fresh 
and sound state. The taste is nauseously bitter, and the flavor 
is very acrid. For pharmaceutical purposes, the coats of the 
sea onion are detached and cut into narrow slices, and dried 
slowly at a temperature not exceeding 200° Fahrenheit. Many 
years ago, Vogel noticed a peculiar principle in squill called 
scillitin, but it is unimportant. 

Squill is emetic, expectorant, diuretic, and in large doses ca- 
thartic. It is given in combination with gum ammoniac, gum 
fetid, tartar emetic, calomel, digitalis, &c, all of which seem to 
modify its action. 

Very large quantities of squill sometimes fail to vomit in 
croup, owing to great vascular fullness in the parts specially 
affected. A few ounces of blood previously drawn from the 
arm, or from the throat by leeches, will obviate the difliculty. 

A very good expectorant pill, well suited to painful coughs, 
may be made as follows : — 

R.— Pulv. scill. £i; 

Pulv. gum ammon. ^ij; 

Ant. tart. grs. ij ; 

Muc. g. Arab. q. s. to make twenty pills. 

One of these given every four hours will make expectoration 
quite free and easy. They may be used advantageously also 
in the asthma of old persons. 

I have treated hydrothorax successfully with pills made of a 
grain of calomel and three grains of squill, and given three 
times a day. 

It has been objected to the frequent use of squills as an eme- 
tic, that the tone of the stomach is impaired thereby; but I 
have never had occasion to notice the circumstance, although 
very much in the practice of employing the medicine in that 
way. Very large doses have greatly irritated the bowels, in- 
ducing spasms and bloody stools. 

The more common preparations of squill are the vinegar, 
syrup, and oxymel. The first, viz., the acetum scillae, or vine- 
gar of squill, is made as follows: — 

Take a pound of dried squill; acetic acid or strong vinegar, 
six pints. Macerate with a gentle heat for twenty-four hours 
in a covered vessel, then squeeze through a linen cloth, and 
when cold bottle the liquor. 

I have not followed this rule when I wanted the article for 



SCULLCAP— ERGOT OF RYE. 735 

my own use, but prefer to make it thus: — Fill a quart bottle 
nearly full of the squill, and then pour in as much acetic acid 
or strong vinegar as the bottle will hold, and allow the bottle, 
well stoppered, to remain undisturbed for a week or ten days, or 
even two weeks. Pour all the liquid on a filter, and place the 
clear liquor in another bottle for use. Then fill the bottle with 
acetic acid as before, and in two weeks the acid will be suffi- 
ciently impregnated with the squill. I have thus acted on the 
same mass of squill four times, and the product was efficient. 

The vinegar of squill is sometimes combined with saltpetre 
in order to augment the diuretic power. From thirty to sixty 
grains may be added to a pint for this object. Obstructions of 
the bronchial tubes, dependent on thickening of the mucous coat 
and mucous accumulation, may often be relieved by an emetic 
composed of half an ounce of vinegar of squill, ten grains of 
ipecacuanha, and an ounce of mint-water. It acts promptly, 
but not severely. 

Syrup of squill may be made by boiling three pounds of 
sugar in a quart of vinegar of squill. A gentle simmering on 
hot coals will answer better than active ebullition. The oxymel 
is made in the same manner, substituting honey for the sugar. 
Both medicines are good expectorants in the dose of from a 
drachm to two drachms, or half an ounce. Larger doses act as 
an emetic. 

An excellent use of the syrup or oxymel is in combination 
with the tincture or milk of assafoetida, for the cure of spasmodic 
or non-membranous croup. I have given it times almost with- 
out number, and have never been disappointed. To a child 
three or four years old, a teaspoonful of each may be given at 
once, and this will frequently calm the irritation. If necessary, 
the dose may be repeated in a half hour. 

Scutellaria Laterifolia. Scullcap. — This plant was ex- 
ceedingly popular many years ago as a remedy for hydrophobia, 
and also as a prophylactic. Dr. Spalding, of New York, pub- 
lished several essays on the excellent qualities of the medicine. 
He gave it in strong infusion and decoction, ad libitum; and in 
many cases it seemed to answer the end. The plant is very 
common in various places in this country, and is a perfectly safe 
agent. 

Secale Corxutum. Ergot of Rye. — A parasitic plant of 
the order fungi is supposed to give rise to this article. It 
grows on the ear of rye, barley, and wheat. From its peculiar 
shape it has been called spurred, because of its resemblance to 
a spur. And since it is most abundant in rye, it is called secale 
cornutum, horned or spurred rye. It is much more abundant in 
some seasons than in others, varying with the predominance of 



736 CAUTIONS ABOUT THE USE OF ERGOT. 

drought or wet. Some persons do not regard it as a fungus, 
but as a disease of the grain caused by the puncture of an in- 
sect. The grain so diseased retains some of its usual character- 
istics, but is for the most part an evident transformation. All 
the ergot I have seen is nearly cylindrical, curved, and striated, 
being of a deep violet color on the outside, and of a lighter color 
within; having a peculiar smell, when dissolved in hot water, 
that cannot easily be mistaken. The fullest account of its na- 
tural history may be seen in the Journal of Prof. Silliman, vol. 
ii., at page 48, to which we refer the reader. 

Ergot was in use out of the profession more than a century 
ago, when it was known as a promoter of parturition. We are 
indebted to the late Dr. Stearns, of Albany, for its general in- 
troduction to the regular obstetrical practice of this country. As 
a partus accelerator it stands alone in Materia Medica, and is 
capable of inducing most felicitous results in the hands of judi- 
cious men, and alike competent to the development of sad results 
when ignorantly or recklessly employed. Ramsbotham, one of 
the ablest obstetricians in the world, was among its most power- 
ful advocates, and the most distinguished men abroad and at 
home have followed his example. And yet I have known a 
professor of obstetrics who denounced it as positively worthless, 
affirming that the hot water in which the ergot was administered 
was the efficient agent. It is well to say, however, that this 
person acknowledged that he had never employed the article 
but once. For any man to talk of the inertia of ergot is like 
making a labored argument to prove that gunpowder is not ex- 
plosive. The grand objection to ergot is its frightful energy 
when injudiciously administered; and if there be a single valid 
reason why it should be discarded, it is its vast potency. 

But it is due to truth to affirm that while ergot is very power- 
ful, it may be so employed as to be safe. Of what good medi- 
cine can we say more? I have never witnessed bad results 
from its administration ; but when it is known that some country 
practitioners carry it in their pockets constantly, and give it to 
save time, right or wrong, we are prepared to hear of disastrous 
consequences. It would be wonderful if they did not occur 
frequently. 

The circumstances justifying and forbidding the use of ergot 
are so well defined that no man need to err in its administration. 
I speak of it now as a 'parturient medicine, and say that if the 
os uteri be dilated some, and the parts be evidently in a dilat- 
able state, wanting only the proper uterine contractions, the 
ergot may be safely exhibited, and its effects will be salutary. 
But, if uterine contractions be pretty strong and regular, the 
os uteri unyielding, and every feature of the case indicating 



POISONOUS ACTION OF ERGOT. 737 

the need of the lancet, ergot must do mischief. Under such 
circumstances, rupture of the uterus will be apt to ensue. Take 
the following illustrations : — 

A French journal reports the particulars of two cases of labor 
in which ergot was employed simply to save time, the labor 
going on in the most natural manner. A drachm was given to 
the women in the course of five minutes. Severe vomitings 
and excessive anxiety came on, and the patients died, one in 
sixteen hours, the other in three days after in consequence of 
rupture of the uterus. 

One of the latest writers on parturition (W. Tyler Smith, 
M.D.) says, "Ergot is a medicine of direct, and not of spinal 
reflex action. It is of extreme value in cases in which, from 
the state" of the passages, there is no danger of laceration or 
rupture. Its action on the uterus through the spinal centre is 
as special as the influence of tartar emetic on the respiratory 
muscles." 

But while it is of vast importance to see that the os uteri and 
the uterine contractions are in such a state as to justify the use 
of ergot, some attention must be paid to the foetus also. Hence 
the truth of the following remark, made by the author just 
named: — "As the ergot of rye affects the life of the child, 
either as a direct poison or by interfering with the materno- 
foetal circulation, it should not be given, if possible, too long 
before the time of birth. The effect of ergot on the uterus is 
peculiar; it not only produces the intermittent pains of labor, 
but it constricts the uterus during the intervals between the 
active pains. On account of the influence of ergot on the child, 
it should not be used until the usual reflex modes of exciting 
the uterus had been tried in vain." 

It has been conjectured that the variable quality of different 
collections of ergot has occasioned the professional discrepancy 
touching its power, so far as that exists. This may be, and 
hence the need of attending a little to that point. M. Boettcher, 
of Menderlutz, made a good many experiments for the purpose 
of ascertaining the truth in this regard, and he reached the fol- 
lowing conclusions, viz., that the action of ergot gathered be- 
fore harvest is very potent, while that collected when harvest 
was over was powerless. 

There is another consideration worthy of notice. If ergot be 
kept in a powdered state, it is in the condition most likely to 
deprive it of oily matter, in which its power resides. Hence the 
necessity of keeping it whole, and bruising it as it may be wanted. 
It is a mistaken notion that good ergot, well preserved, must 
lose its power in a few months, and that hence it requires to be 
obtained every year. I kept a parcel seven years, without any 



738 PREPARATIONS OF ERGOT. 

special care, and it was as efficient as when first placed in the 
bottle; the only precaution was to keep a tight cork in the bot- 
tle, and that tied down by means of bladder and sheepskin. It 
is stated that the addition of a few grains of camphor will exert 
a preservative influence, but I have not tried it.* 

The action of ergot on a system in full health, and not preg- 
nant, is injurious if it be taken in considerable quantity. Severe 
contractions of the muscles, amounting to slight opisthotonos, 
pains in the head, delirium and vertigo, have been induced. 
These are not the ordinary effects of an inert medicine. 

The constant use of bread into which ergot enters is de- 
cidedly deleterious, and has proved to be so on a very broad scale. 
The grain has been promiscuously gathered, ergot and sound 
ears, the whole being ground into flour. In Silesia, a dry gan- 
grene became epidemic from this cause, and raged in the years 
1096 and 1588, being occasionally seen during the intervening 
years. Whitlaw, the author of a queer book on some new dis- 
coveries, says he detected ergot as the cause of a similar disease 
in this country, and especially in the State of New York, many 
years ago. And although some writers have boldly ridiculed 
the statements, they are neither, for that reason, unphilosophical 
nor false. 

The Gazette Medicate, 1844, has the case of a child, ten years 
old, in whom the ergot induced gangrene of the legs, demanding 
amputation. In a child twenty-eight months old, spontaneous 
amputation of the right leg ensued, and the child got well. The 
ergot was probably taken in food, but it is not so stated. 

Various results have followed the examinations of ergot with 
a view to determine its ingredients. It is agreed that it is spe- 
cifically lighter than water, and that it contains neither starch, 
gum, sugar, nor gluten, as rye does; that it is resolved into 
two coloring principles, the one a fawn, and the other a violet- 
colored matter; also a sweetish oleaginous substance, a free acid, 
ammonia, and a vegeto-animal substance, tending rapidly to pu- 
trescence. Other and later experiments assure us that it con- 
tains a highly poisonous and a medicinal ingredient, which may 
be entirely separated, thus securing all the valuable properties 
of the ergot unmixed. One of these is a reddish-brown extract, 
very soluble in hot water, possessing in the highest degree the 

* Some specimens of ergot, procured for analysis by a celebrated cbemist, 
were found to be only plaster of Paris casts, colored in imitation of ergot. The 
active principle is said by some to reside in the outer covering, which is liable 
to be washed away by a heavy rain, and that fine dry weather is essential to 
make good ergot. A peculiar worm also may impair the article, by consuming 
the active portion. It is certainly more apt to spoil in powder than if entire. 

The above may account, in part, for the diversity of results obtained from 
ergot by different physicians at different times. — Adulteration of Medicines, p. 87. 



PREPARATIONS OF ERGOT. 739 

valuable obstetrical and haemostatic properties so long ago con- 
ceded to the spurred rye. The other is a fixed, colorless oil, and 
decidedly poisonous. 

Ammoniacal and ethereal solutions have been proposed, to 
facilitate the administration and operation of the medicine. Of 
these the latter is to be preferred; and it can be made by acting 
on any quantity of bruised ergot by sulphuric ether, for ten days 
or two weeks, in a tight vessel. Thirty drops of this ethereal 
oil or tincture are equal to a drachm of the solid ergot. A wine 
of ergot has also been proposed, but it is not needful. I regard 
the infusion, made by pouring hot water on the bruised article, 
as the best plan for its administration, from fifteen to thirty 
grains being a dose. If the parts be in a proper state, as before 
mentioned, such a dose, in two or three ounces of warm water, 
will soon induce active contractions of the uterus, and the dose 
may be repeated in twenty minutes if needful. 

An instructive case is reported in one of the journals, in which 
thirty-grain doses, frequently repeated in the early stage of 
pregnancy, in order to arrest hemorrhage, brought on delirium, 
coma, vertigo, sloughing of the parts, and ultimately death. 

Dr. Patterson, in the Dublin Journal of Medical Science, 
May, 1844, gives the following case: — Two drachms of ergot 
were given in a single dose, in a case of accidental hemorrhage, 
in which the membranes were ruptured. All the usual means 
failed to induce the desired contractions. The dose was repeated 
in an hour, and then the pains came on with decided efficiency, 
resulting in delivery. 

In this brief history, we learn that very large doses, under 
peculiar circumstances, may do no harm, but result in real ad- 
vantage to the patient. Such facts are to be met with in other 
journals. 

The excito-uterine action of ergot is further displayed by the 
following case, reported in the Phila. Bulletin of Med. Sciences, 
1843 : — A female, as a consequence of the absence of the men- 
strual discharge, (probably suppression,) was seized with violent 
hysterical symptoms. It was determined, after trial of other 
means, to use the ergot. A scruple, mixed with sugar, was 
given, in divided doses, in the course of a day, and the practice 
continued for three days, intermitted on the fourth, and then 
repeated. The catamenial flow appeared, and the hysteria 
vanished. — Dr. Nardo. 

The above, and kindred facts, have led to a general belief in 
the emmenagogue powers of ergot. The Medico- Ohirurg. Rev. 
for 1835 contains several interesting cases, showing the happy 
effects of the medicine in this relation. The mode of adminis- 
tration was as follows : — Two drachms were infused in a quart of 



740 HAEMOSTATIC POWERS OF ERGOT. 

boiling water, in a covered vessel, for one hour, and a small tea- 
cupful given every half hour. From one to two days' use of the 
medicine sufficed. 

Dr. Hoffman, of Berlin, recommends the ergot in high terms 
for the relief of after-pains. He gives five-grain doses every 
two hours, with a little powdered cinnamon merely to aromatize. 
The pains and hemorrhage seem to be augmented at first, but 
they speedily diminish, and disappear entirely. The action would 
appear to be at first stimulant, and then sedative. 

The effect of ergot in the expulsion of uterine polypi is also 
worthy of notice. We cannot fail to detect here the high utero- 
excitant power of the medicine. The polypi are really foreign 
bodies, which nature, unaided, cannot get rid of. The ergot in- 
duces such positive contractions as to break off the morbid con- 
nection and expel the mass. 

Mr. Harris and others have substituted uva ursi for ergot in 
obstetric practice, and regard it as being preferable in many 
cases. The uva ursi does not induce such violent contractions 
as the ergot, and therefore is safer for mother and child. From 
a scruple to a drachm is the dose. The ergot of wheat has also 
been employed as a substitute. 

Dr. Negri has shown conclusively the haemostatic powers of 
ergot. Hence the successful treatment of epistaxis, haemoptysis, 
hcematemesis, &c, with five-grain doses, given every fifteen or 
twenty minutes, or even once in an hour. Alarming hemorrhage 
from the gums, resulting from the extraction of a tooth, has 
promptly yielded to this treatment. The remedy is supposed 
to act, in all such cases, in virtue of its nauseant quality, which 
accelerates the closure of the bleeding vessels. — Edinb. Med. 
and Surg. Journ., 1834. 

It must be conceded (as Dr. Smith has said, in his late work 
On Parturition) that the opposite action of ergot in arresting 
hemorrhage and bringing on a sanguineous flow, seems to in- 
volve the notion at least of a paradox. But we think the solu- 
tion applied in the case of opium is fitting here, viz., that the 
variable and perhaps unascertained state of parts under a morbid 
influence will so modify the operation of the same remedy as to 
make it a stimulant or sedative. We believe this to be the actual 
and only relief to the difficulty. 

The diuretic property of ergot has been very much praised by 
Dr. Theriano, an Italian physician, whose paper may be found 
in the Journal de Qhimie Medicale for 1839. The following 
case seems to be satisfactory: — An aged man had been compelled 
to use the catheter very frequently in order to relieve his dis- 
tended bladder, but was finally relieved of this difficulty by the 
use of ergot. Two scruples, mixed with as much green tea, were 



SEDATIVES — SEMOLA. 741 

infused in a pint of boiling water ; when cool, he took three large 
tablespoonfuls every fourth hour, and by the persistent employ- 
ment of the medicine for several days, not exceeding a week, he 
was cured. A similar case is furnished in another periodical, 
in which the prescription was to divide twenty grains into six 
powders, to be taken in the course of a day. The dose was in- 
creased to ten grains, and with the most palpable diuretic power. 
The man was cured. 

M. Payen has given his testimony in the Edinb. Med. and 
Surg. Journ. for Oct. 1842, to the salutary operation of ergot 
in paraplegia. After the persistent trial of ordinary means, the 
patient was put on the use of fifteen grains of ergot daily, the 
dose being augmented gradually to thirty grains. Irritant lini- 
ments were kept to the spine during the treatment, and no doubt 
exerted a good influence. It is affirmed that no unpleasant cir- 
cumstances marked the use of the doses named, and that recovery 
began to be obvious in from fifteen to thirty days. 

We cannot but think that the paraplegia must have depended 
on some comparatively trivial cause; and we presume that diffi- 
culty in urination led to the trial of the ergot. 

The last fact we name, touching the therapeutic application 
of ergot, is more novel and singular than the one just adverted 
to. We find it in the Medical Examiner for Nov. 1848. Ex- 
cessive dilatation of the pupils, from the action of belladonna, is 
reported as very promptly yielding to the fine powder of ergot, 
taken as common snuff. The dilatation disappeared in a few 
seconds, but soon returned. The remedy was repeated, and the 
pupil completely restored to its natural state. 

Sedatives, from sedo, to ease or assuage. — These have been 
divided into direct and indirect sedatives. The first, or direct 
sedatives, are any agents that depress the vital energies without 
the intervention of any previous excitement by the same source. 
Such is blood-letting, as when enough of the vital fluid is de- 
tracted at a single operation to induce complete syncope. Long- 
continued cold will exert a positive prostrating influence, from 
which the system cannot rally. 

An indirect sedative is any agent whose obvious primary action 
is to elevate the system above the par of healthy excitement, 
from which it sinks to a point below the natural standard when 
that agent is withdrawn or is not repeated. It is in this manner 
that a full dose of opium proves an indirect sedative. 

Semola. — This is a new article of diet, said to contain nearly 
sixty per cent, of wheat gluten, with pure wheat starch so com- 
bined as to be exceedingly nutritive, and therefore well suited to 
cases of debility. (See London Lancet, April, 1850.) I am not 



742 SENNA. 

aware of its introduction as yet into this country, and hence can 
say nothing from personal experience. 

Senn.e Folia. The leaves of Senna. Cassia Senna. — This 
plant grows abundantly in Upper Egypt, and the leaves are im- 
ported in great quantities into Europe and this country from 
Alexandria, and hence the name Alexandria Senna. Adultera- 
tions are constantly practiced by mixing the leaves of other 
plants with the leaves of senna, and it is not easy to guard 
against the fraud. Besides the senna just named, the Tripolitan 
and East India varieties are spoken of; and it is said that each 
of these is adulterated. 

The marks of a good senna are a bright, fresh, yellowish-green 
color, with a peculiar and not disagreeable odor, somewhat like 
that of green tea. The fewer stalks and seed-pods and broken 
leaves and dirt, the better is the article, for all these increase the 
weight and lessen the medicinal power. When senna is chewed 
for a few minutes, we are conscious of a nauseous flavor that is 
quite peculiar. Boiling water develops sufficient coloring matter 
to give a brown appearance to the infusion, which has the nause- 
ous taste and smell in a concentrated state. As this infusion is 
apt to spoil in hot weather, it should be made in small quantities, 
as occasion may require. Alcohol takes up the active powers of 
the plant efficiently, and a brown tincture is formed. 

A peculiar proximate principle, called cathartine, has been 
separated from senna by the French chemists ; but the process 
is too tedious for detail here, and the product is unimportant. 

Few persons can take senna alone without experiencing more 
or less of griping pains, and hence the term drastic has been 
applied to it. This effect is readily prevented by adding to a 
teacup of the decoction or infusion a teaspoonful of cremor tartar. 
Strange as it may seem to those who have not tried the mixture, 
it is a fact that the union of these articles (which separately 
employed will often gripe) presents a mild and pleasant cathartic, 
that is admirably suited to females who require an aperient soon 
after delivery. On the same principle, too, the addition of a 
little Epsom salt, Rochelle salt, phosphate of soda, manna, and 
aromatic seeds, after the manner of the French, divests senna of 
all unpleasant tendencies, so that the complex mixture referred 
to is very highly prized. 

I have long been satisfied that mistake has prevailed in regard 
to senna infusion. My plan is to prepare it as strong as it can 
be made, and instead of two drachms in a pint of boiling water, 
I prefer to add an ounce, or a half-ounce at least. Cover the 
vessel tight, and let it stand undisturbed until it becomes suffi- 
ciently cool for use. Then pour the contents on a fine gauze, and 



PREPARATIONS OF SENNA. 743 

bottle the liquor for subsequent administration. If an ounce of 
senna entered the infusion the product will be so concentrated 
that a smaller quantity than usual will answer for a cathartic ; 
and that is a point of some importance in respect of young 
children. 

I have heard objections raised to decoctions of senna, but ex- 
perience has dissipated them all. With a perfectly clean earthen- 
ware vessel, furnished with a close lid, I can prepare a decoction 
of senna that will purge promptly and mildly, if cremor tartar 
be added in the way named above. The boiling need not 
last over ten minutes, and the product will have much more 
cathartic power than any mere infusion. The experiment has 
been too often made to admit of anything like reasonable 
doubt. 

What is called the compound infusion of senna is prepared 
with an ounce and a half or two ounces of senna leaves, a drachm 
of bruised ginger-root, and a pint of boiling water. Macerate 
during an hour, and strain. A few cloves may be added in 
place of the ginger, if agreeable, or any other spice may be 
substituted. This infusion should be prepared only as it is 
needed, because by long keeping it deposits a yellowish precipi- 
tate that gripes and nauseates. The addition of Epsom salt 
or cremor tartar improves the properties of the infusion very 
materially. 

We may modify this compound infusion variously, to suit dif- 
ferent tastes and preferences. Thus : — 

Take of the compound infusion, ^iv; 
Epsom salt, 
Syr. ginger, aa £ss; 
Mint- water, ^ij. 

Mix, and give to an adult a wineglassful every hour until it acts freely. 

A compound syrup of senna is kept in the drug stores, and 
is a convenient article. It is not difficult to prepare a syrup 
from the compound infusion above named. The addition of suffi- 
cient sugar and suitable cooking over hot coals will give the 
result. 

Senna may be managed so as to be nearly void of its peculiar 
taste and other unpleasant quality. Take two, three, or four 
drachms, and infuse in eight ounces of boiling water for the space 
of ten or twelve hours, in a covered vessel. Strain through a fine 
gauze, and fill a teacup two-thirds full, adding new milk to fill 
the vessel. The mixture looks not unlike a cup of coffee, and has 
very little taste. The celebrated Baudelocque employed this 
preparation at the Children s Hospital in Paris, and found it to 



744 VIRGINIA SNAKEROOT. 

operate smartly without griping, sick stomach, or any other 
unpleasant result.* 

Children take senna very readily when intimately rubbed with 
perfectly ripe figs. An ounce of the leaves made as fine as pos- 
sible, and half a pound of the softest, ripest figs, well incorpo- 
rated, furnish a mixture of which a piece as large as a walnut 
will purge. Not only do children relish this figgy senna, but I 
have known adults who were exceedingly partial to it. 

Senna and soft prunes can be managed in the same way. Take 
half an ounce of senna, half a drachm of cremor tartar, and half 
a pint of water ; boil on a slow fire for about ten minutes, and 
strain. To the clear liquor add half an ounce of sugar and half 
a pound of prunes, and simmer on hot coals till the liquor is 
nearly all absorbed by the prunes or evaporated. A soft extract 
is thus procured which will act on the bowels gently. For a 
child four years old a piece as large as a medium nutmeg will be 
a dose. 

Or to a pint of strong senna infusion add half a pound of soft 
prunes and three ounces of sugar ; simmer slowly until the mix- 
ture is complete and homogeneous. A tablespoonful taken every 
hour will soon purge. The infusion or decoction of senna may 
also be employed, in the way of injection, alone or with the addi- 
tion of Glauber's or Epsom salt. 

The American senna is a less efficient article than those of 
which we have been speaking. 

Serpentarlze Radix. Aristolochia Serpentaria. Virginia 
Snakeroot. — HYns is indigenous to the United States, and is 
known to the country people in almost every section. Many 
farmers gather it in great quantities at their leisure, and vend it 
to city or village druggists. The root abounds with innumerable 
fibrillse, exceedingly thin, having a light-brownish aspect, a some- 
what pungent, bitter taste, and a pleasant aroma. It is held to 
be stimulant, diaphoretic, and tonic. 

As this and the senega polygala are both familiarly termed 
snakeroot, it is well to remember the points of distinction. The 
branching out from a small knob into very minute fibrous radi- 
cles, not thicker than stout thread or small twine, is so peculiar 
to the Virginia variety that it ought never to be mistaken for 
the root of the thickness of a little finger and with no fibrilbe, 
that marks the senega or seneka. The brown color of the former, 
and the grayish appearance of the latter, are also safe guides, 

* Dr. Lintlmer advises to administer senna as follows: — Infuse one, two, or 
three drachms in one or two teacups of cold water, all night. Use the strained 
infusion to make coffee for the next morning, just as if it were only water. The 
product will be an aperient void of the senna taste, and which does not gripe. 
— Medical Times and Gazette, Dec. 1856. 



VIRGINIA SNAKEROOT — MUSTARD. 745 

especially when associated with the greater pungency of the latter 
and the more pleasant odor of the former. 

Virginia snakeroot is rarely administered in any other forms 
than infusion or decoction. An ounce to a pint of boiling water, 
macerated for the space of four hours and strained, will give a 
good infusion, the dose of which is a wineglassful every three or 
four hours. The force and pleasantness of the infusion is some- 
times augmented, thus : — 

R. — Infus. serpentar. ^iss ; 
Pulv. serpentar. grs. x ; 
Syr. zingib. ^ij. 
Mix, and repeat three or four times a day. 

The warm infusion acts chiefly as a diaphoretic. If taken cold 
it proves gently tonic, and this property is augmented by the 
addition of Peruvian bark. 

Some thirty-five or forty years ago it was the almost universal 
practice to treat autumnal fevers with decoctions of Peruvian 
bark and Virginia snakeroot. These were so exceedingly feeble, 
when contrasted with the modern sulphate of quinine practice, 
that we are disposed to wonder how any one recovered under the 
old and obsolete system. The contrast will compare pretty well 
with the ancient mode of stage travel and the present flight by 
railroads. 

As a tonic merely, in the period of convalescence from an 
attack of fever, an infusion made of an ounce of Peruvian bark, 
as much snakeroot, and a pint of boiling water, will often be 
useful. The infusion should stand for several hours and then 
be strained. A wineglassful may be taken every three or four 
hours. 

Chronic rheumatism is sometimes relieved by draughts of hot 
infusion of serpentaria. It stimulates gently, and induces per- 
spiration. 

Sinapis Semina. Mustard-seed, black and ivhite. — The 
activity and acrimony of the seeds reside in a volatile oil, 
which is separated by distillation. They yield a fixed oil also, 
by pressure, and abound in mucilage, starch, and something like 
gluten. 

White mustard-seed has long been a favorite medicine in the 
treatment of rheumatism, indigestion, &c. The dose is a tea- 
spoonful three times a day. It may be given in molasses, or 
syrup of any kind. It is too stimulant to be proper when fe- 
brile symptoms are present. The black mustard is employed 
by very many in country locations for the same purposes as the 
white ; and I never detected any real difference in their operation 
or effects. 

The ground mustard has been very much employed as an 

48 



746 MUSTARD — SINAPISMS. 

emetic in the early treatment of Asiatic cholera in this country. 
Two drachms of the flour, or the same quantity of fresh-ground 
seeds, in a half-pint of hot water, will act as an emetic, with the 
advantage of leaving the stomach and system in a less depressed 
condition than it is after the use of other emetics. I have no 
doubt that the mixed stimulant and emetic operation exerts a 
favorable influence on the stomach in reference to the subsequent 
use of opium, or opium and calomel combined. 

The effect of a weak solution of this article, as above, con- 
trasts forcibly with the daily table use of a concentrated aqueous 
or acetous mixture, such as we employ at our dinners, especially 
when we partake of fatty meats. Here the design is to prevent 
sickness of stomach and to invigorate it for the right disposal of 
gross food. 

The term sinapism, so familiar to the profession, is derived 
from the word sinapis, and it imports a plaster, cataplasm, poul- 
tice, or other application, prepared from ground mustard, or the 
flour, as it is often called. As a large portion of the mustard 
sold in the stores is an adulterated article, it is preferable to 
grind mustard-seed for the occasion when a sinapism is needed. 
Then we can have no doubt as to the purity of the article. 

To prepare the sinapism some persons add water, others vine- 
gar, and occasionally spirits of turpentine and cayenne pepper, 
in order to increase the cutaneous effect. The mustard is seldom 
mixed alone, an equal quantity of wheat or rye flour being com- 
bined with it, and the whole made into a paste so as to allow of 
being spread out on a cloth. The action of sinapisms is in the 
nature of counter-irritation or revulsion, and we place them in 
the list of rubefacients. 

The promptitude or tardiness with which a sinapism acts de- 
pends very much on the actual condition of the system at the 
time. I have known an intolerable burning to be induced be- 
fore the plaster could be properly secured in its place, and its 
instantaneous removal was necessary. More frequently I have 
been greatly disappointed, either by the delay of action or the 
feebleness of it when it did occur. In one instance, no action 
could be induced at the time, and in a week or ten days after, 
high irritation, burning, and the like, were manifest in the places 
where the sinapisms had been applied. 

It is important to give specific directions in respect of the 
removal of sinapisms. Neglect of this has induced deep and 
painful ulcerations that might have been avoided by timely care. 
It is proper to direct the removal at the end of half an hour, and 
to have the sinapism shifted to another spot, if the first trial 
failed. 

The London Lancet for June, 1850, contains a brief history of 



soda. 747 

a fatal case in a girl six years old, ascribed to the mistaken 
use of sinapisms. She labored under an eruptive fever, with the 
glands of the neck very much swollen. A linseed poultice was 
ordered for the neck, but a mustard plaster was substituted. 
This was not the grand mistake, after all. The plaster was kept on 
three hours, and two others were applied soon after. Frightful 
gangrenous inflammation ensued, which proved fatal. 

We have in this item the true ground of fault-finding with 
blisters and sinapisms. In the first place the swollen glands did 
not call for a sinapism at all. Flannels wrung out of warm 
water would have been far preferable. But in this case the 
length of time the plaster was allowed to remain fearfully aggra- 
vated the mischief. 

The oil of mustard is sometimes employed as an external ap- 
plication, but the ground seed is preferable. 

Soda. Oxide of Sodium, formerly called mineral alkali, na- 
tron, help, barilla. — Barilla, kelp, and natron are impure varieties 
of soda. It has been called mineral because found in seams 
and crusts with mineral bodies. The ashes of a marine plant, 
the salsola soda, furnish impure soda by lixiviation, as in pre- 
paring potash. The plant is cultivated largely on the Mediter- 
ranean coast of Spain, where the soda is prepared for commercial 
purposes. If the same plant be taken to an interior location, 
fifty miles from the sea, it will not yield soda. The inference is 
properly made, therefore, that on the sea-coast the plant washed 
by the sea is capable of decomposing the muriate of soda in sea- 
water and appropriating the soda to itself. 

Pure soda is exceedingly caustic, and hence the term caustic 
soda. It is obtained in the same manner as indicated for the 
manufacture of pure or caustic potash. ■ The caustic soda is not 
employed in practice. 

Carbonate of soda is obtained in a pure form from the articles 
above-named, by lixiviation and crystallization. It dissolves in 
twice its weight of boiling water. The crystals are efflorescent, 
fuse at 50° Fahr., and lose their water of crystallization, chang- 
ing into a white and friable mass. The article called sal soda, so 
much employed in the process of washing clothes, is an impure 
carbonate. The term subcarbonate has been applied under the 
impression that the acid is deficient and the alkali in excess. In 
the exactly neutral salt the alkaline taste predominates, and the 
solution changes vegetable blues to green. Four hundred and 
sixty grains of diluted sulphuric acid neutralize one hundred 
grains of dry carbonate of soda, and thus we judge of the alka- 
line strength of the salt. 

The incompatibles are the same as those of carbonate of 
potash. 



748 USES OF CAKB. SODA. 

Fourcroy contended for the medicinal use of the soda carbonate, 
in preference to that of potash, because soda is found in the 
animal economy always, while potash is seldom present. In the 
neutral state, and in the form to be noticed presently, it is very 
largely employed as an antacid, the effect depending on a direct 
chemical action. As an antilithic it is more frequently resorted 
to than potash, because its long continuance as a remedy is better 
sustained by the stomach. Twenty grains per day, in mucilage 
of gum Arabic, or in a glass of Seltzer water, will correct acidity 
and lessen the tendency to deposits of red sand in the urine ; 
and this dose may be repeated daily for two or three weeks, 
when it should be substituted by lime-water or magnesia. 

When there is obvious deficiency of tone in the alimentary 
canal, we may advantageously combine the carbonate with some 
of the bitters, as the compound infusion of gentian ; half an 
ounce of the infusion, a scruple of the carbonate, and a table- 
spoonful of cinnamon-water, mixed, may be taken two or three 
times a day. 

When carbonate of soda is employed for a long time in con- 
siderable quantity to cure the uric acid diathesis, it may so neu- 
tralize the acid as to put the earthy matters in excess and give 
a white deposit to the urine. Hence the necessity for care in 
the administration. As a proof of the speedy action of car- 
bonate of soda on the urinary organs, it is said that two drachms 
taken in the morning on an empty stomach, in a cup of tea, 
have induced sensible changes in the urine in ten minutes, and 
that in three hours the urine was decidedly alkaline, though not 
so before. 

In respect to the habitual use of any variety of carbonate of 
soda, it is well to remember that it may exert a pernicious in- 
fluence, softening and even eroding gradually the coats of the 
stomach, and more frequently inducing incurable indigestion. 
The proper advice is to change the antacid every two or three 
weeks, and so to get all the benefit of the antacid medicine 
without incurring the risk of the continued use of any one 
article. 

Dr. Maxwell, surgeon of the United States Army in China, 
thinks he has made a discovery in respect of the power of the 
carbonate of soda as an antidote for Asiatic cholera, and he has 
made a communication to the Secretary of State, at Washington, 
on this subject. He says that the instant a case of cholera is 
presented he gives the carbonate in teaspoonful doses dissolved 
in gruel or water, and drank as hot as the patient can bear. 
This allays the pain and burning of stomach, produces sleep, and 
restores the heat of skin and pulse in a very short time. If 
the dose was thrown up, it was repeated with a few drops of 



USES OF CARB. SODA. 749 

laudanum and a full dose of oil, so as to cause the antidote to 
pass down as speedily as possible to the poison in the small in- 
testines. When any portion of the oil and antidote passed in 
the evacuations, convalescence was found to have already com- 
menced, the patient soon passed urine, and was then out of 
danger. The antidote should be continued morning and even- 
ing, if necessary, only reducing the dose. — Philadelphia Medi- 
cal Examiner, November, 1849. 

Such of our readers as are familiar with the practice of Dr. 
Stevens, so .much talked of in 1832, will not fail to perceive that 
the discovery of Dr. Maxwell does not differ essentially from the 
saline treatment of Stevens. This was very abundantly tested 
in this country at that time, and although sometimes successful, 
it was often unavailing. 

Carbonate of soda has been highly spoken of by Hufeland as 
a remedy for goitre. He prefers it to iodine, because it is less 
apt to derange the digestive organs. Two drachms of the salt 
are dissolved in six ounces of balm tea, with the addition of half 
an ounce of syrup of cinnamon or ginger, and a tablespoonful is 
given four times a day. 

The carbonate is not often administered in the form of pill, 
because not easily prepared, unless the water of crystallization 
is expelled, or soap added to make a suitable pill mass. 

The celebrated Alibert treated scald head with signal success 
with carbonate of soda. The same practice was adopted in 
several medical institutions of Paris, where more than fifty thou- 
sand persons have been cured. The hair was directed to be 
shaved off and the scalp washed daily with a solution of carbon- 
ate of soda and an infusion of walnut leaves alternately. An 
ointment, consisting of a drachm of the carbonate and an ounce 
of lard well mixed, was rubbed into the scalp, which was then 
covered with a piece of blotting paper. A mild bitter infusion 
was given at the same time, and some mercurial if a syphilitic 
taint could be detected. 

Soda poultices were formerly much in use as local appliances 
for the relief of pain in chronic gout and rheumatism, but they 
have gone into disuse, and should be revived. Dr. Bennet has 
derived great benefit from them lately in the wards of St. Thomas's 
Hospital, and it is known that the late Dr. Pereira was partial to 
the practice. To prepare them, add one drachm of soda to a 
common bread and milk poultice, and apply it every night as hot 
as it can be borne. A little more soda would do no harm. — 
Braithwaite, part xxix. p. 46. 

Warm baths of water charged with carbonate of soda have 
been very useful in relieving the severe pains of gout and rheu- 
matism in the feet and ankles. 



750 BI-CARBONATE OF SODA. 

Bi-carbonate of soda differs from the carbonate in the fact of 
containing an additional equivalent of carbonic acid. It is made 
by passing carbonic acid gas freely into an aqueous solution of 
the carbonate. The bi-carbonate, although containing two equiva- 
lents of acid, is alkaline to the taste, and makes vegetable blues 
green. It is more pleasant as a medicine than the carbonate. 

, The genuine soda-water is an aqueous solution of carbonate of 
soda, with excess of carbonic acid. What is generally sold for 
soda-water has no soda in it, and is only water highly charged 
with carbonic acid gas. 

It is well for physicians to be aware of the fact that gastric 
pain, and even something very like lead colic, has been induced 
by freely drinking soda-water at the fountains kept in drug stores. 
These fountains are sometimes furnished with leaden tubes and 
have a copper lining. From both these circumstances the water 
may acquire a deleterious quality. 

A fraudulent imitation of soda-water has been effected by add- 
ing a few drops of sulphuric acid to a solution of carbonate of 
soda and instantly corking the bottle. This fraud can be detected 
very easily by adding a drop or two of solution of chloride of 
barium (mur. barytes) to the suspected water until precipitation 
ceases. On treating this precipitate with diluted nitric acid, if 
any portion remains undissolved it proves the presence of sul- 
phuric acid in the solution. 

The bi-salt is frequently called super carbonate, and is a good 
antacid and antilithic, in twenty or thirty-grain doses, taken in 
a tablespoonful of water three times a day. Great quantities of 
it are appropriated to the manufacture of soda powders, which, 
are put up in boxes in white and blue papers, one containing 
thirty grains of bi-carbonate of soda, the other thirty grains of 
tartaric acid. The contents of each paper are dissolved in two 
tumblers one-third full of water, and when the powders are dis- 
solved the contents of the tumblers are mixed and drank in the 
act of effervescence. The bi-carbonate is instantly decomposed 
by the tartaric acid, and its carbonic acid is evolved, tartrate of 
soda remaining in solution. The powders, frequently taken, 
prove at length mildly aperient. 

Bi-carbonate of soda and tartaric acid may be kept in a state 
of intimate mixture, and employed as an effervescing draught 
may be needed. It should be packed in a glass bottle, and well 
stoppered, so as to exclude moisture. A teaspoonful of the mix- 
ture dissolved quickly in a half-pint tumbler of cold water makes 
a very pleasant draught. 

The bi-carbonate is sometimes made into lozenges by admix- 
ture with white sugar, mucilage of gum Arabic, and oil of pep- 



BI-BORATE OF SODA. 751 

permint. The mixture is properly divided into convenient-sized 
masses, which are resorted to for the relief of indigestion. 

Muriate of Soda. Chloride of sodium. Common salt. Sea 
salt. Fish salt. Bay salt. Rock salt. — These terms indicate 
one and the same thing. Sea-water, salt springs, salt licks, salt 
wells, furnish the basis whence, by evaporation, we get the com- 
mon salt so well known and estimated. 

The benefit of sea-water as an external remedy depends chiefly 
on the salts it contains, including the muriate of soda, hydriodate 
and hydrobromate of potash, &c. And the efficacy of bathing 
with salt water for the relief of indolent tumors depends on the 
same combination. 

An aqueous solution of common salt was highly recommended 
by Dr. Rush as an anthelmintic, a copious draught being taken 
night and morning. It is stated, in the Transactions of the Col- 
lege of Physicians of London, that two pounds dissolved in two 
quarts of water were taken at a single dose, for the cure of 
worms. The same salt was frequently given in powder by Dr. 
Rush, disguised by trituration with a few grains of cochineal, in 
order to conceal it from the ignorant. This device is entirely 
justifiable, as there are many persons who could not be induced 
to take the salt if they krftw it was prescribed, however much 
it might benefit them. I presume that the use of common salt 
as a vermifuge was based on the sad consequences resulting to 
criminals who were deprived of salt, as was the custom in Hol- 
land ; the intestinal canal being impacted with worms as the 
necessary result of the deprivation. 

Injections of common sea-water have been successfully em- 
ployed in the treatment of gleets. Patients who had been affected 
for more than two years were completely cured in ten days. — 
Edinburgh Medical and Surgical Journal. I see no reason why 
a weak solution of common salt would not answer quite as well. 

Burns and scalds have been successfully treated by Lisfranc 
with the common salt, and the remedy was very probably in use 
long before he was born. It is a very old practice in some parts 
of Great Britain to cover a burnt or scalded surface instantly 
with common house salt, fresh from the barrel, and undissolved. 
I have known a case in which a very crude application of the 
remedy gave instant relief and prevented vesication. 

A watery solution of the salt is also an old remedy for ophthal- 
mia, and has been revived by a writer in the Edinburgh Medical 
and Surgical Journal for 1844. 

Bi-borate of soda. Borate of soda. Borax. — Although this 
salt has two equivalents of acid to one of base, it has an alkaline 
reaction. All the mineral acids, potash, the sulphates and muri- 
ates of the earths, are incompatible. 



752 BORAX. 

Borax has long been employed to cure sore mouths, and it was 
therefore called detergent. It is thus used in the cases of chil- 
dren now, and sometimes for adults. Mel boracis, or honey of 
borax, is one of the forms resorted to for this end. To make it, 
mix a drachm of the fine powder of borax with an ounce of good 
honey, so as to incorporate them as perfectly as possible. The 
addition of borax to balm tea is very commonly made when a 
pleasant gargle is needed. The fine powder of borax and white 
sugar, equal parts well mixed, and applied to small ulcers of the 
mouth in adults as well as children, will often exert a healing in- 
fluence. The best mode of application is on the end of a finger, 
gently moistened, and laid directly on the sore spot. 

The peculiar irritation of the throat, mouth, and gums, occa- 
sioned by mercurials, is often allayed by the following mixture, 
to be used as a wash to the parts several times a day : — 

]&. — Pulv, sod. bi-bor. gij ; 

Infus. ros. comp. ^viij ; 

Mel. pur. 5ss. 
Mix. 

Dr. Rhinehart, of Prussia, employed a strong solution of borax 
in scaly tetter of the hand, with great success. The solution con- 
sisted of half a drachm of the borax to an ounce of water, and 
was employed twice a day. 

Efflorescence of the face, so very annoying to young persons, 
females especially, has been treated with a solution of borax with 
happy results. The prescription is borax, two parts ; orange 
flower and rose-water, each fifteen parts. With this mixture the 
face should be washed five or six times a day. — Bulletin de 
Therap., August, 1851. 

Dr. Eflenberger stated to the Vienna Medical Society, in 1850, 
that he had been successful in cases of gangrenous bubo by apply- 
ing a solution of borax, made by adding one or two drachms to 
a pint of water. The solution was applied by means of soft lint, 
which should be changed at least three times a day. Fifty cases 
were so treated in one year. 

A writer in the Western Lancet has strongly urged the use of 
borax in dysmenorrhoea. "In plethoric habits," says the author, 
"I take from four to six ounces of blood from the veins of one 
of the lower extremities, and repeat the venesection, if neces- 
sary, and keep the bowels open by Epsom salts. For two days 
previous to the appearance of the menses I order a warm foot- 
bath every evening and morning, and give borax in the following 
formula : — 

R. — Bi-bor. sod. gij ; 

Infus. sem. lini, t :fvij. 
Mix, and give a tablespoonful every two hours. 



SULPHATE OF SODA. 753 

The pain was relieved by a grain of the extract of henbane, given 
every half hour." 

Prof. Meigs regards the following prescription as admirably 
suited to relieve pruritus vulvce of pregnant women : — 

R. — Sodae bi-bor. ^ss; 

Morph. sulph. grs. vi; 

Aq. rosar. ^viij. 
Mix, ut fiat lot. 

This should be applied three times a day with soft sponge or 
linen, first washing well with tepid soapsuds. 

The same mixture will answer well for itching of the scrotum 
in males. 

Borax is a novel article to be given as an injection in the treat- 
ment of diarrhoea. It is in the idiopathic form of the disease in 
children, when it is catarrhal in its nature and hard to manage, 
that borax often does service. It acts on the mucous membrane 
of the bowels as it does on the mucous membrane of the mouth 
in aphthous affections. Borax has the advantage over other arti- 
cles that it is not irritating, and is alkaline. The following is the 
formula of M. Bouchut. He calls it the alkaline lavement. 

Borax, giv to gvi ; 
Sugared water, |jiv. 

If more borax be used, there must be more water, in order to 
hold it in solution. — Dublin Medical Gazette, February, 1855. 

Sulphate of Soda. Glauber $ salt. Sal mirabile, or the won- 
derful salt. — The latter name was applied in the early history of 
the article, when no other saline cathartic was known. The salt 
has a peculiar saline, bitterish, yet cooling taste. It dissolves in 
three parts of cold and in one of boiling water. The crystallized 
salt contains more than a third of its weight of water of crys- 
tallization, which is lost by exposure to the air, the salt falling 
into a fine white powder. This has been thought by some to be 
of no value, when in fact the medicinal power is more than equal 
to the same weight of the crystals. 

The unpleasant taste of this salt is readily removed by a little 
lemon-juice, or cremor tartar, or vinegar ; but it is seldom em- 
ployed now because of the extensive use of Epsom salt. From 
half an ounce to an ounce will purge. 

M. Puchelt, a German physician, affirms that two scruples 
of the sulphate of soda will correct or prevent the unpleasant 
effects that sometimes attend the use of a grain of opium ; and 
to make the result certain, it should be repeated two or three 
times a day.* 

* Schultz found, in a man who took an ounce of sulphate of soda each day for 
two days in succession, that the amount of fibrine in the blood was lowered from 



754 CHLORIDE OF SODA. 

Phosphate of soda is sometimes used as a cathartic in this 
country. It is soluble in four parts of cold and in two of boil- 
ing water. It has a saline taste, without the unpleasant bitter- 
ness of Epsom or Glauber's salt. It is the sal perlatum of the 
old books, and was first introduced to notice by Dr. Pearson. 
Because of its almost total insipidity it has been also named the 
tasteless purging salt. It is a very pleasant medicine, and very 
popular in France. Two ounces make an adult dose ; and it may 
be taken in gruel or broth, imparting no more taste than ordinary 
table salt. 

Tartrate of potash and soda. Soda tartarisata. Sal Seig- 
nette. Rochelle salt. Sal de doubus, &c. &c. — It is a salt of 
two bases and one acid, is slightly efflorescent, and readily solu- 
ble in water. It can be made by adding bi-tartrate of potash to 
a solution of carbonate of soda at a boiling heat, so as to neu- 
tralize the excess of tartaric acid. The proportions are three 
hundred grains of the carbonate and four hundred grains of cre- 
mor tartar dissolved in water, and boiled until action ceases. The 
result on due evaporation is the compound salt of tartrate of pot- 
ash and soda. 

This salt presents a very pleasant, gentle variety of cathartic 
medicine, and is agreeable to all who employ it. It enters the 
composition of the effervescent aperient known as Seidlitz pow- 
ders. These consist of two different powders, whose solution in 
separate vessels, and subsequent commixture in one, furnish a 
very grateful carbonated drink. One of the powders contains 
one hundred and twenty grains of tartrate of potash and soda 
mixed with forty grains of bi-carbonate of soda ; the other con- 
tains thirty-six grains of tartaric acid. Carbonic acid is evolved 
from the decomposed bi-carbonate, and the fluid taken into the 
stomach holds tartrate of potash and soda in solution. Two or 
three of these powders drank in the course of an hour will 
usually act gently on the bowels. From half an ounce to an 
ounce of the tartrate of potash and soda will suffice for a mode- 
rate cathartic, the action of which is facilitated by the use of 
warm gruel. 

Chloride of soda is important because of its chlorine qualities, 
and it has acquired considerable celebrity as a disinfectant. It 
differs from chloride of sodium (which is only muriate of soda 
dried by a strong heat) in being a compound of soda and chlorine, 
or an oxide of sodium somehow united to chlorine gas. The pre- 
cise nature of the union has occasioned much discussion, and is 
not, perhaps, well understood. Some have supposed that the 

5 to 1.9 in 1000 parts. This must be explained by supposing that the anaplastic 
saline, by its entry into and presence in the blood, had hindered the formation of 
this fibrine. Hence the utility of sulph. soda as an anti-inflammatory medicine. 



LIQUID CHLORIDE OF SODA. 755 

oxide of sodium or soda absorbed the chlorine somewhat as char- 
coal absorbs various gases. This seems to have been the opinion 
of Dr. Ure. A chloride of an oxide appeared to many a con- 
tradiction in chemical terms not easily reconciled. 

Pure chloride of soda is prepared by passing a current of chlo- 
rine gas into a cold and diluted solution of caustic soda until no 
more can be taken up ; or, in other words, until the soda is satu- 
rated with the gas. It is said that common carbonate of soda 
will answer as well as the caustic soda, but that more chlorine is 
requisite in order to displace all the carbonic acid gas. The 
celebrated disinfecting liquid of Labarraque, or liquid chloride 
of soda, is soda fully charged with chlorine gas, and is regarded 
by many as the strongest preparation of the kind manufactured 
anywhere. I have never met with anything superior to it as a 
disinfectant. 

The liquid chloride of soda is well suited to remove all offen- 
sive odors, as of sewers, privies, dissecting rooms, foul ulcers, 
hospitals, &c, and has been successfully employed in all these 
relations. For the same reason it has been tried as a counter- 
agent of pestilential fevers, as a decomposer of morbid effluvia ; 
and, as some say, with success. It is certain that very foul 
apartments are often speedily purified by sprinkling chloride of 
soda over the floor, and by placing it in saucers in chambers. 
The extrication of the chlorine is so gradual as not to injure the 
respiratory organs in the smallest degree, and when extricated it 
combines chemically with the hydrogen of the offensive gas or 
vapor, and both are neutralized so as to be imperceptible. 

The bottles of chloride of soda should always be kept perfectly 
tight, so as to prevent the escape of any of the chlorine ; and 
this should be particularly attended to whenever a portion is 
poured out for use. With due care a bottle may be preserved in 
good condition for a great length of time. 

The liquid chloride is extensively employed in medical prac- 
tice, especially for its disinfectant and stimulant qualities. I 
know of nothing better to relieve the mouth made sore by saliva- 
tion. One or two drachms should be added to two or three 
ounces of water, and the mixture employed as a wash frequently. 
Healing is promoted, and the offensive condition of the breath 
is neutralized. The ulcerated throat in scarlatina maligna is 
happily treated by the same wash or gargle, making it some- 
what stronger of the chloride. In gangrenous sore mouth. Dr. 
Bonneau, of Guersent, employed the following mixture with 
success: — 

R. — Decoct, hordei, ^iij ; 

Chlorid. sod. liq. £i; 

Cons. ros. ^i. 
Mix. 



756 USES OF CHLORIDE OF SODA. 

R. — Decoct, cinchon. ^iij ; 

Syr. aurant. ^i ; 

Liq. chlor. sod. 5i; 
Mix. 

These were used very frequently as lotions, and also as gargles, 
alternately. 

Dr. Chopin speaks very favorably of the application of the 
liquid chloride to excoriated nipples, where I suppose it acts 
partly by its cleansing agency. It should be applied several 
times a day, with a hair pencil. 

In addition to the large number of remedies for burns and 
scalds, the chloride of soda has been named as well entitled to 
consideration. I have never had an opportunity of testing its 
value in that respect, but can speak very decidedly of its efficacy 
in the treatment of tinea capitis. A case presented in the West 
that had been at least six months under treatment. I attended to 
the digestive organs of the child, and corrected their aberrations ; 
and then, having had the scalp softened and cleansed with poul- 
tices, it was washed three times a day with two drachms of the 
chloride combined with an ounce of water. In less than a week 
a manifest improvement gave assurance of complete success, 
which was fully realized in the course of two or three weeks. 

The liquid chloride has also been given internally in malignant 
scarlet fever, and in low fevers of a typhoid character, with a 
view to neutralize what has been called the typhoid or adynamic 
element that seems to give fatality to those diseases. A mixture 
of two drachms in three ounces of water, administered frequently 
in teaspoonful doses, has seemed to meet the case. In low fevers, 
with looseness of the bowels and very fetid discharges, it has been 
employed also by injection. The half of such a mixture as that 
just named may be thrown up at once, and repeated in two 
hours. The effects are a happy stimulation and correction of the 
offensive odor, both of which are important considerations. The 
editor of the Cyclopedia of Practical Medicine has the fol- 
lowing judicious remarks, confirmatory of the foregoing state- 
ment : — 

" The chloride of soda is a valuable medicine in all the typhoid 
forms of fever, when judiciously prescribed. It may be given 
early in the putro-adynamic variety, when excitement is imper- 
fect or low and the skin discolored, or petechia are appearing, 
and continued throughout the disease. But when vascular reac- 
tion is considerable, or local determination prominent, particu- 
larly in the nervous and exanthematic varieties, this substance 
should be withheld until these states are subdued or about to 
lapse into the nervous stage. At first it ought to be prescribed in 
small doses, so as not to offend the stomach, in from ten to fifteen 



USES OF CHLORIDE OF SODA. 757 

drops of the solution as prepared by Labarraque, every three or 
four hours, in camphor julep or in an aromatic water. As the 
disease passes into a state of exhaustion or of manifest putro- 
adynamia, or when there is a lurid skin, low muttering delirium, 
stupor, meteorismus, black sordes on the tongue, teeth, &c, the 
supine posture, unconscious offensive evacuations, petechia, 
blotches, a disposition to gangrene in parts pressed upon, coma, 
&c, it should be given in larger doses or more frequently, and 
in tonic infusions or decoctions, or with camphor, serpentaria, or 
other stimulants and tonics. I have seen it productive of great 
benefit in such cases ; but it should be commenced before these 
symptoms appear, and be persisted in, as its good effects are sel- 
dom manifest in less than three or four days, or more ; and it 
should not supplant the use of wine, opium, suitable nourishment, 
and other means which the stage of the disease and peculiarities 
of the case may suggest. It should also be frequently adminis- 
tered in enemata ; and the surface of the body ought to be often 
sponged with a stronger solution of it in warm water, with the 
addition of camphor. M. Chomel has lately given the chloride 
of soda an extensive trial ; and he states that it has proved more 
successful in low fevers than any other means, when persever- 
ingly employed. Dr. Graves has also recently employed it, and 
has found it extremely serviceable. It acts first on the tissues, 
with which it is brought in contact, as a gentle stimulant and 
antiseptic ; and is most probably partially decomposed in the di- 
gestive organs and reduced to the state of common salt. In this 
state it is carried into the circulation, where it supplies the waste 
of this substance that has taken place in the early stage of the 
disease." 

In harmony with the above is the testimony of a writer in the 
Edinb. Med. and Surg. Journ. for 1842, who strongly recom- 
mends the internal use of the liquid chloride in diarrhoea induced 
by, or connected with, ulceration of the intestinal glands. 

The silicate, and the benzoate of soda have been employed, 
recently, in the treatment of gout and rheumatism, by two phy- 
sicians, who furnished a paper, with the results, to the Academie 
Imperial de Paris. They say that the silicate facilitates the 
elimination of uric acid, and that its influence may be extended so 
far as to render the urine alkaline. It is also said to act as a 
tonic to the digestive organs. The benzoate transforms the' uric 
into hippuric acid, the combinations of which are very soluble, 
while those of uric acid are hardly soluble at all. At the same 
time colchicum was given, to carry out of the system the re- 
mains of uric acid thus changed, and aconite was applied to 
the parts where the severest pain was located. — Brit, and For. 
Med.-Chirurg Rev., Jan. 1857. 



758 NIGHTSHADE — SOOT. 

Solanum Dulcamara. Woody Nightshade. Bitter Sweet. 
— This plant was once highly valued, and some physicians ap- 
pear to regard it favorably at this day. But it seems to me that 
it has no just claims to our notice, and should be discarded. 

Solutions. — This term has been given to a variety of medi- 
cinal compounds, and will probably continue to be employed, al- 
though," perhaps, not really necessary. We retain it in accord- 
ance with custom, and present a few samples of this variety of 
mixture. 

Iodine Solutions. Refrigerant Solution. 

1. R.— Iodine, 9ss ; R.— Nit. potass. 5ss ; 

Iodid. potass, or \ . Hydrochlor. ammon. zffi ; 

Hydr. pot / 6 > A ,^ 

Aquse, Svi. — , ? , J . 

Dissolve the hydriodate in the water, Dissolve, and add 

and then add the iodine. We thus make ™ y : ca ™P hor8e > 3«» i 

Lugol's solution. The strength can be Alconoi, £i. 

regulated as desired. Dose, teaspoon- Mix - Dose, a tablespoonful in bar- 

ful for an adult. ley-water. 

**■ tt j ' y '• Solution of Acetate of Morphia. 

Aquae, ^vi. R. — Morph. acet. grs. xx; 

Mix as above. For external use to Aquae, ^i ; 

scrofulous eruptions. Acid. acet. If) x ; 

Caustic Iodine Solution. ' & 

R.-Iodine, ^ss; Mix ' Dose > five to twent ^ dro P s ' 

Hyd. pot. ^i; 

Aquse, ^ij. Prussic Acid Solution. 

Mix. To be used externally o . . ■, -, A ~ 

J R. — Acid, hydrocyan. ^ss ; 

Rubefacient Iodide Solution. Alcohol, ^i; 

R.— Iodine, siv ; Aquse, -|xii; 

Hydr. pot. Si ; Plumb, acet. ^i. 

Aquse, Svi. ^ x - ^ or external use, to allay 

Mix. itching. 

Soot. — Wherever wood is burned as an article of fuel, this 
agent can be obtained at little cost, save the value of the time 
needed for its collection. Being a domestic remedy, it has some 
claims to our regard, and is too much neglected. It is decidedly 
antiseptic, and may be considered a feeble modification of creosote 
or pyroligneous acid. Lotions of soot have long been employed 
by the French physicians in the treatment of ulcers, cutaneous 
affections, &c. The common direction for preparing the lotion 
is to- boil two handfuls of soot in a quart of water for the space 
of half an hour, and to apply the strained liquor to the parts at 
least four times a day. A similar, but weaker, decoction has 
been recommended as an application to burnt and scalded sur- 
faces. A handful of soot in eight pounds of water, boiled down 
to three pounds, is the preparation spoken of in the American 
Journal of Medical Sciences for Jan. 1842. Pledgets of lint 



PINK ROOT. 759 

are directed to be thoroughly soaked in the decoction, and ap- 
plied two or three times a day. By reference to the article 
Creosote, it will be seen that a very weak solution of that article 
has been successfully applied, under like circumstances. 

An ointment of soot, made of half an ounce of soot and two 
ounces of fresh lard, has been frequently resorted to for the 
healing of indolent ulcers. 

There is scarcely an old lady in the country who has not heard 
of soot tea as a remedy for infantile colic. It is one of those 
traditionary relics that has passed from generation to generation, 
and continues to be approved in the nursery. It is mildly an- 
tacid and carminative. A teaspoonful of soot will make an ordi- ■ 
nary teacupful of boiling water sufficiently strong. A few tea- 
spoon doses will suffice. 

A tincture of soot (tinctura fuliginis) has been employed for 
flatulent colic, with frequent success. A tablespoonful of the 
subjoined mixture is a dose for an adult : — 

Take of wood-soot, !|ij ; 
Assafoetida, ^ss ; 
Proof spirit, ibij. 
Digest for the space of ten days, and filter. 

Spigelia Maeylandica. Maryland, Indian, Carolina Pink 
Root. Perennial Worm Gf-rass. — This is a very common and 
well-known plant in the United States. The whole plant is pos- 
sessed of medicinal properties, but many persons employ the 
root only. It was known at a very early period as an an- 
thelmintic, and employed in that relation by the aborigines of 
this country. The apothecaries have been in the habit of keep- 
ing two kinds for sale ; one made of all parts of the plant inter- 
mixed, the other consisting wholly of the roots. Every physi- 
cian should purchase the latter, even at treble the price of the 
former, because of its superior value. I speak thus from per- 
sonal acquaintance with the article. 

Two modes of exhibiting this article as a vermifuge are in use. 
The first is to give a decoction or infusion per se, for several 
days, and then to exhibit a carthartic so as to operate smartly 
'on the bowels. The design is to destroy the worms by the 
spigelia, and to carry them out of the body by purgation. Others 
prefer to make a compound infusion or decoction of pink root 
and senna, and so to secure at once the compound anthelmintic 
and cathartic property. The latter is the plan which I have been 
in the habit of recommending, and for the following reason : 
The exhibition of the pink-root tea is sometimes attended by un- 
pleasant cerebral development, which is occasionally alarming. 
There is now and then some vertigo, and frequently a good deal 



760 SPONGE PESSARIES. 

of dilatation of the pupil. These are avoided by the use of the 
compound infusion. 

An ounce of the root infused for a few hours in a pint of boil- 
ing water, then gently simmered over hot coals and strained, is 
the customary mode for preparing the tea, as it is called. The 
whole of this is to be given to a child twelve years old in the 
course of ten hours, and followed on the next day with infusion 
of senna and Epsom salts. The only difference as respects the 
compound tea consists in the addition of an equal quantity of 
senna. 

Sometimes the powder of the root is administered to small 
•children in doses of ten to twenty grains, mixed with syrup, 
which may be repeated two or three times a day. 

Dr. Jas. Clark, in 1796, published some facts in relation to 
the vermifuge powers of the spigelia, and named the following 
as an excellent mode for exhibiting it. A strong infusion is 
made of the entire plant in boiling water, and to this a quantity 
of the rind of sour oranges or lemons is added, and also some 
of the juice. The mixture is strained, and boiled to a syrup with 
Muscovado sugar. A tablespoonful or two of this syrup given 
to a child from two to six years old, thrice a day, for two days, 
and followed by a dose of castor oil on the next day, rarely fails 
to expel a great many round worms. Dr. C. remarks that the 
medicine was seldom given to children under two years, and that 
it was deemed necessary to confine them to a dark room, as the 
light made them giddy, caused dilatation of the pupils and pain 
in the eyeballs. If too large doses be taken, they induce cere- 
bral derangement, which is easily removed by a spoonful or 
two of lime-juice and water, and by washing the face with cold 
water. "Employed in proper doses," says Dr. C, "I never 
knew it to do any serious harm." 

Not a few of the patent worm medicines sold in all parts of 
the country consist chiefly of the spigelia. 

Spongia Officinalis.' — The Mediterranean and Red Seas, as 
also the West Indies, furnish varieties of sponge. The composi- 
tion of sponge, free of corals, shells, sand, &c, is gelatine and 
coagulated albumen. When it is burnt, the ashes are found to 
contain silex, carbonate and phosphate of lime, carbonate of soda, 
chloride and iodide of sodium, bromide of magnesia, and some 
oxide of iron. 

Sponge Tents are employed in surgical practice. They are 
strips of sponge saturated with melted wax, so that when in con- 
tact with the animal fibre the heat of the parts gently melts the 
wax ; moisture is absorbed by the sponge and it swells consider- 
ably. Hence the dilating power of sponge tent. 

Sponge Pessaries. — The whole class of solid pessaries should 



spoons. 761 

be blotted from existence as a positive nuisance. The little 
sachets of Leuret are a hundred-fold better, and the sponge 
pessary a thousand times more valuable. They should be made 
of well-cleaned soft sponge, of a size large enough to fill the 
vagina to slight distension, and should have a tape or string 
annexed. There should be a dozen on hand, and all made per- 
fectly clean by immersion in the water of chloride of lime. 
They may be dipped in warm water before being passed up, or 
in sugar of lead water, or in port wine diluted, or in any of the 
astringents in solution. Their yielding nature secures, their 
accommodation to the vagina more exactly and remedially than 
any pessary ever invented. Their medicinal quality restores 
lost tone, and helps greatly to keep the uterus in its right posi- 
tion. They should be changed twice a day. 

Burnt sponge is an old remedy for goitre and scrofulous affec- 
tions generally. On the continent, not a few physicians now 
prefer it to the preparations of iodine, to the presence of which 
the burnt sponge owes part of its efficacy. The adult dose of 
the powder of this article is a drachm, mixed with a little honey 
or molasses, and ginger or ginger syrup. 

To prepare burnt sponge, the common article of commerce is 
cut into small pieces, then beaten, to free it of stony particles, 
after which it is heated in a covered iron vessel till it becomes 
quite black and friable. The mass is then to be pulverized. 

Spoons for dispensing medicinal agents are of more import- 
ance than is generally imagined. They should be of pure silver, 
in order to guard against accidents such as that referred to 
below. 

Dr. C. Woodward, of Cincinnati, relates in the Western Lan- 
cet a case of destructive inflammation of the eye, which he is led 
to believe was caused by chemical reaction taking place between 
a solution of nitrate of silver and a German silver spoon, into 
which it was poured previous to being applied to the eye. The 
patient was a child about two years old, of scrofulous diathesis. 
At the period of the first visit, the eyelids presented externally 
a red, tumid, and glazed appearance, and was in so irritable a 
condition that it was found impracticable to examine satisfactorily 
the internal condition of the organ. There were very consider- 
able febrile excitement, with a slight eruption, somewhat resem- 
bling rubeola, over the face and neck, and superficial ulcerations 
studded the posterior fauces. After appropriate treatment the 
inflammation was sufficiently subdued to admit of an examina- 
tion of the cornea and general conjunctiva. The conjunctiva of 
the lids was found to be red and thickened, and covered with 
coagulable lymph, but the cornea was transparent, perfectly free 
from ulcerative action, and apparently not the least endangered 

49 



762 STIMULANTS. 

by the neighboring inflammation. A solution of nitrate of silver, 
in the proportion of one grain to the ounce of distilled water, was 
ordered, which was dropped into the eye from a German silver 
spoon. In twenty-four hours from the first application, and 
after the solution had been introduced into the eye three or four 
times, the cornea was examined ; but instead of the clear trans- 
parency of the preceding day, the entire anterior surface of the 
globe of the eye was found covered with a thick, albuminous 
opacity, completely obscuring the cornea, and looking as if an 
active caustic had been passed over it and had entirely disorgan- 
ized the superficial tissues. This went on to ulceration, sta- 
phyloma, and, finally, the loss of the vitreous humors of the eye. 
We have said that the spoon used for dropping the solution into 
the eye was composed of German silver, which metal is composed 
as follows : — nickel, one pound ; copper, three and a half pounds ; 
zinc, one and a quarter pounds. At the request of Dr. Wood- 
ward, Dr. E. A. Hildreth, now of Wheeling, Va., made some 
experiments with a solution of nitrate of silver dropped from a 
German silver spoon on the eyes of cats and dogs. In the cat 
the experiment failed, the failure being attributed to the mem- 
brana nictitans preventing the solution from touching the surface 
of the eye. In the dog, however, the destruction of tissue and 
loss of sight were complete. 

According to Dr. Hildreth, the following chemical changes 
occur when a solution of nitrate of silver is placed on German 
silver : — 

The nitric acid unites with the copper, nickel, and zinc, form- 
ing nitrates of those metals, and the oxide of silver is precipi- 
tated. The nitrates are all soluble in water. Now copper has 
a much stronger affinity for the nitric acid than either of the 
other metals, and consequently ought to deprive the nickel and 
zinc of it. In the present case, it can only be explained by 
granting that the nitric acid is in excess for the copper, and, be- 
cause they unite in definite proportions, there will be a part of 
the nitric acid free, which part unites with the nickel and zinc, 
forming nitrates, the affinity of these two metals for the acid 
being about equal. 

Stethoscope. — An instrument for exploring the chest, and 
designed to assist the ear in the investigation of diseases of the 
lungs and heart especially. (See Auscultation.) 

Stimulants. — The Latin word whence this term is derived 
signifies a sting or spur. Hence we understand why it is affirmed 
that a stimulant applied to the skin induces a sense of heat, 
with pain, and makes the part red. Hence, too, the propriety 
of speaking of a feeling of warmth in the stomach when an 
internal stimulant is swallowed. 



STRYCHNIA. 763 

Under the action of pure stimulants, the nervous energy is 
roused, and the muscular contractility is more manifest. If the 
stimulant be repeated at proper intervals, the effects will con- 
tinue. 

Diffusible stimulants differ from others of a more permanent 
nature in their more evanescent action, which calls for fre- 
quent repetition of the dose. The ethers are plain instances of 
this class, while the stimulation of opium is decidedly more per- 
sistent. A full dose of sulphuric ether may accelerate the pulse 
as obviously as a full dose of opium ; but the acceleration will 
endure much longer in the latter than in the former case. 

Stimulants are useful and necessary for the relief of enfeebled 
vital energy when it is not attended by inflammation ; no mat- 
ter whether the debility flows from profuse hemorrhage or other 
profluvia, or from positive syncope. And yet the use of this 
class of remedies calls for great caution and good judgment. 

True stimulants are only of use by counteracting that failure 
of the nervous force which hinders the manifestation of the vital 
strength, which is stored up somewhere in the system. For to 
exalt nervous force is not necessarily to exalt vital force, since 
anything which tends to destroy the former must at length re- 
press and extinguish the latter. In such a case as syncope, or 
stoppage of the heart on account of a sudden nervous shock, 
stimulants are specially proper ; also in the last stage of fevers, 
asthenic pneumonia, &c, where the existence of life is endangered 
by a great loss of nervous power. — Headland's Action of Medi- 
cines, p. 260. 

Strychnia. Strychnine. The alkaloid base of the strych- 
nos nux vomica. — This powerful constituent of several species of 
vegetable matter was first separated by Pelletier and Caventou, 
in 1818. They obtained it from the strychnos nux vomica, a 
magnificent tree, a native of the islands of the Indian Archi- 
pelago. The seeds are flattened, depressed in the centre on one 
side, convex on the other, and covered on both sides with a vel- 
vet-like surface. From these seeds or beans the active principle 
is obtained in considerable quantity, and is known to exist in 
them in combination with igasuric acid. A pound of the seeds, 
well managed, yields thirty-four grains of pure strychnia. The 
same quantity of the bean of St. Ignatius yields one hundred and 
two grains. The purest kind of strychnia has been obtained 
from a species of Upas. 

The nux vomica was early used as a medicine by the Hindoos, 
and its nature and properties understood by Oriental doctors 
long before it was known to foreign nations. " Dog-killer" and 
" fish- scale" are two of its Arabic names. It is stated that at 
present the natives of Hindostan often take it for many months 



764 ACTION OF STRYCHNIA. 

continuously, in much the same manner as opium eaters eat 
opium. They commence with taking the eighth of a nut a day, 
and gradually increase their allowance to an entire nut, which 
would he ahout twenty grains. If they eat directly "before or 
after food, no unpleasant effects are produced; but if they ne- 
glect this precaution, spasms result. 

To procure strychnia from the beans of the stryehnos nux 
vomica, they are rasped as fine as possible, and macerated in 
successive portions of water. The liquor is then evaporated to 
the consistence of syrup, and the gum is thrown down by addi- 
tion of alcohol, which forms a tincture, which is to be evaporated 
in close vessels by the heat of a warm bath. A yellowish-brown 
colored extract is left, which is redissolved in cold water to re- 
move some fatty matters. The strychnia is then precipitated 
by lime-water from this solution. The igasurate of strychnia is 
thus decomposed, an igasurate of lime being precipitated, and 
the strychnia being taken up by the addition of alcohol. In this 
state some brucia is present, which is made evident by the action 
of nitric acid, which strikes a deep red with brucia, but not with 
strychnia. 

The purest strychnia is in minute, elongated, prismatic crys- 
tals, though sometimes it is in a granular form. It is inodorous, 
and so intensely bitter that a single grain gives obvious bitter- 
ness to eighty pounds of water. Like the other vegetable alka- 
loids, strychnia is scarcely soluble in water, requiring more than 
six thousand parts for solution at 50° F., and twenty-five hun- 
dred parts of boiling water. It is not very soluble in sulphuric 
ether, nor in cold alcohol, but readily soluble in boiling alcohol. 
When quite pure it is white, unchanged by the air, but decom- 
posed by a slow heat. 

Besides combining with acids, strychnia unites with iodine, 
forming important compounds that are potent as therapeutical 
agents. 

Igasurate of strychnia being the active principle of nux 
vomica, whatever may be said of strychnia as a remedy may be 
considered as applicable to the other substantially. In all 
forms, pure or combined, strychnia is a powerful stimulant, ex- 
hibiting its influence by increasing the energy of the whole sys- 
tem, and then acting on those tracts of the spinal marrow that 
give origin to the motor nerves. The nerves of sensation are 
also involved in this action, for, along with the muscular contrac- 
tions and convulsions which supervene, the surface of the body 
is highly sensitive, and susceptible of the slightest impression. 
Even the motion of the air becomes a source of uneasiness, 
almost as great as that of water to a hydrophobic patient. Prior 
to the twitching or tetanic convulsions during the use of this 



ACTION OF STRYCHNIA. 765 

article, patients experience a sensation of heat, pricking, &c. 
These increase, subside, and return. 

The first effect of strychnia on the digestive organs is in- 
creased energy of the digestive powers. The appetite is im- 
proved, the food better assimilated, and the patient looks better. 
The circulation is not perceptibly affected, and yet if the dose be 
too large, respiration is oppressed and a sense of suffocation 
occurs. The urinary organs are but little affected, but the cuta- 
neous system feels the influence very powerfully; the capillaries 
are excited, and a copious sweat breaks out. 

The effects of strychnia on inferior animals, birds, &c. are 
important, as serving to confirm its remedial powers. When 
dogs swallow twenty or thirty grains of powdered nux vomica, 
they soon become evidently tetanic, have distortion of the limbs, 
tremors, convulsive movements of the face and eyelids, immo- 
bility of the eyelids, and complete muscular rigidity, with invo- 
luntary flow of urine. Cats, rats, foxes, minks, crows, &c. are 
all powerfully affected by the article. Strychnia is now sold in 
large quantities for the purpose of killing crows and minks. 
Meat impregnated with the poison very promptly kills. Corn 
soaked in the alcoholic tincture is equally fatal, if the alcohol 
be pure and plenty of strychnia be added. When the alcohol is 
weak and but little of the alkaloid employed, the crows, although 
they swallow the corn greedily, are only made a little drunk, as 
was noticed by some farmers in Peoria, Illinois. 

A solution of nux vomica injected into the pleura of a dog 
induced tetanus and death. Similar results followed its applica- 
tion to wounds, but it was inert when laid on the sound skin. 
The watery decoction injected into the jugular vein brought on 
tetanus very speedily, which terminated in death. 

While the examination of the dead body detected no token of 
inflammation, the general contraction of the arterial system was 
too obvious to escape notice. It is not to be expected that any 
very palpable lesion could be seen after so speedy a death as 
follows a fully poisonous dose. 

It was held by Magendie and others that strychnia does not 
act through the medium of the nerves, but is absorbed and car- 
ried by the blood to the spinal column, on the anterior nerves of 
which its immediate influence is exerted. But when it is re- 
membered that tincture of iodine acts as an antidote to strychnia, 
by changing its nature in the stomach, and that the influence of 
the poison is promptly arrested if the stomach be emptied by 
a powerful emetic, there is reason to doubt the correctness 
of Magendie's view, and to believe that the operation is by the 
nerves. That strychnia, in very large doses, operates directly 
on the origin of the motor nerves, is obvious from the symptoms 



766 ACTION OF STRYCHNIA. 

that follow, viz., violent tetanic spasms, rigidity of the voluntary 
muscles as well as those of respiration, immobility of the chest, 
and hence defective decarbonization of the blood; add also from 
the evidence afforded by the experiments of Fodere, who found 
that on exposing the spinal marrow of an animal to which 
strychnia had been given, he could produce convulsions by pres- 
sure on the anterior segment of the cord. Experiments have 
also shown that strychnia produced no effect on the system when 
the spinal marrow had been destroyed. 

It was long ago observed that paralysis might occur in the 
lower extremities, independently of any affection of the brain, 
and physicians were led to refer the disease to some morbid 
change or impression on the motor tract of the spinal cord. It 
may probably be induced by powerfully sedative impressions on 
the extremities of the nerves which supply the intestinal canal, 
as in painter's colic. As this palsy has been cured by strychnia, 
it gives additional proof that the alkaloid operates through the 
medium of the intestinal nerves. On the supposition that para- 
plegia depended on palsy of the anterior nerves of the spine, and 
aware of the influence of nux vomica on this set of nerves, Dr. 
Fauquier, of Paris, tried it as a remedial agent in this disease. 
He gave it in the form of powder and extract, with decided ad- 
vantage. Fauquier observed that the paralytic parts appeared 
to be more sensible to the impression of nux vomica than the 
sound ones, and his success with the nux led him to try strychnia 
in like circumstances. The experience in the use of the latter is 
already extensive; and although sometimes injurious, is often a 
useful stimulant in palsy of the lower extremities. My own 
experience has not been very favorable to its administration, 
although I have not employed it very frequently. 

As some persons may feel disposed to try the nux vomica in 
preference to strychnia, it is proper to say that in some respects 
their effects are different. The extract determines powerfully 
to the head, whereas strychnia and its salts evince scarcely any- 
thing of the kind. This is decidedly in favor of strychnia. It 
should not be forgotten, however, that in all palsies with great 
determination to the head, venesection should be premised before 
either nux vomica or strychnia is administered. There is a 
case reported, however, in which strychnia induced all the symp- 
toms of intoxication, although it very rarely affects the head 
at all. 

The alcoholic extract of nux vomica has been administered, in 
sick headache of an obstinate character, by Dr. McCaw, of Vir- 
ginia. The dose is one-twelfth of a grain to begin with, and 
increased to a quarter-grain. The pills are to be taken for a 



USES OF STRYCHNIA. 767 

fortnight, and then suspended for as long a period. — Virginia 
Medical Journal, 1857. 

Pure strychnia is very generally preferred to any form of nux 
vomica. It is more uniform than the extract, and hence is safer. 
It is necessary to be very careful in exhibiting strychnia. As an 
alkaloid, uncombined, it is comparatively insoluble ; and its ac- 
tivity will depend on the greater or less acid state of the stomach. 
The more acid in the stomach the more active the strychnia, be- 
cause the salt formed will be more soluble. Hence the danger 
of patients using strychnia and vegetable acids, as lemonade, 
vinegar, and the like, at the same time. These acids, joining 
the strychnia, form salts, which, by their great solubility, vir- 
tually double or treble the dose. It is much better to give the 
acetate or some other salt of strychnia at once. The acetate is 
readily made by adding a grain of the alkaloid to a drachm of 
distilled vinegar. Every six-drop dose of this solution contains 
a tenth of a grain of strychnia, and the administration can be 
regulated with great accuracy. I regard this as decidedly the 
best method for giving the alkaloid. 

Magendie directs the combination of strychnia with conserve 
of roses. Two grains are to be intimately mixed with thirty of 
the conserve, and divided into twenty-four pills, each of which 
contains a twelfth of a grain. He orders a tincture, also, to be 
made of three grains to a drachm and a half of alcohol. Three 
drops, which make a dose, contain a tenth of a grain of strychnia. 

The tincture is a much safer preparation than the pills, be- 
cause it demands great care to insure an equable distribution of 
the active agent, so as to have just a twelfth of a grain in each 
pill. I prefer the acetic solution to either, and think all will be 
pleased with it who give it a fair trial. 

In many cases of palsy obvious relief follows the use of 
strychnia in two or three weeks, while others resist it entirely, 
no matter how long its use is continued. The declaration has 
been made very positively that paralysis of sensation is not 
curable by strychnia, while that of motion is very generally. 
But the assertion has been too sweeping altogether. The Lon- 
don Medical Gazette for June, 1845, reports a case of palsy of 
motion and sensation in an arm and leg of a female, aged twenty- 
nine, who was cured by taking seventy grains of strychnia in 
two months, beginning with a sixteenth of a grain, and gradually 
increased, so that she took three-grain doses before a week ex- 
pired. My son, Dr. B. Rush Mitchell, of the U. S. Navy, re- 
ported a case in the Western Lancet, in which palsy of sensation 
and motion was cured by the same medicine ; and I have seen 
one case of a similar kind. 

Strabismus, evidently paralytic, and of twelve years' standing, 



768 USES OF NUX VOMICA. 

was completely cured in seven days by the application of a solu- 
tion of twelve grains of strychnia in two ounces of alcohol, to the 
eyebrows and temples, morning and evening. (See Western 
Lancet, Jan. 1847.) 

Dr. Stevenson, of Calcutta, relates some cases of success in 
the use of strychnia to blistered surfaces to cure amaurosis of 
several years' standing. Half a grain was applied twice a day, 
on the temple, until tremors of the limbs were induced. He 
employed a like practice successfully in partial palsy of the 
limbs. — JV. American Medical and Surgical Journal, vol. viii. 

The local application of strychnia was also successful in the 
following case, copied into the Western Lancet : — 

"A habitual drunkard, aged fifty-six, was admitted into the 
Glasgow Royal Infirmary, having suddenly lost the power of the 
left forearm and hand ten days previously. The sensation of 
the parts was perfect, but the power was much impaired ; he had 
no headache ; the bowels were costive after free purging ; a blis- 
ter was applied to the back of the forearm, and one-eighth of a 
grain of strychnia sprinkled over the vesicated surface. On each 
successive day the application was increased by adding the origi- 
nal quantity to that of the preceding day, till it amounted to one 
grain, after which one-fourth of a grain, instead of one-eighth, 
was to be added. From the second week the improvement was 
manifest ; no obvious constitutional effect ensued, and the patient 
was dismissed cured at the end of five weeks from the commence- 
ment of the treatment. In another patient, affected with paralysis 
of the flexor muscles and diminished sensation of the right leg, a 
cure was effected in the course of six weeks." 

Prolapsus ani, evidently paralytic in its nature, was soon 
cured by the following preparation of nux vomica : — Four 
scruples of salep were boiled for twenty minutes in three and 
a half ounces of water, and to the strained liquor three-fourths 
of a grain of the extract of the nux were added. A teaspoonful 
of the mixture was given so frequently as to consume the whole 
in twenty-four hours. This treatment was employed in young 
children. — JEdinb. Medical and Surgical Journal, July, 1846. 

Dr. Schwartz treated the same disease with the same medi- 
cine. He dissolved two grains of the extract in two drachms of 
pure water, and gave from six to ten drops every four hours. 
He affirms that the disease is generally cured in twenty-four 
hours, or greatly relieved. To children of eighteen months or 
two years old he gave fifteen-drop doses, and continued the 
medicine for about a week after the cure, in order to prevent 
a relapse. For children of six months old three-drop doses 
suffice. 

I have treated incontinence of urine with strychnia with de- 



USES OF STEYCHNIA. 769 

cided success, and regard it as a capital remedy when the disease 
is clearly a paralytic derangement. Dr. Moudiere has reported 
the happy effects of mix vomica in the same disease, in the 
Archives Generates for 1836. His formula is as follows : — 

R. — Ext. nuc. vom. grs. viij ; 
Ferri oxyd. nig. gi. 

Mix intimately, and divide into twenty-four pills, and give one 
three times a day. After twelve were taken by a patient the 
incontinence disappeared; but, to prevent a relapse, the pills 
were continued until twenty-four grains of the medicine were 
consumed. Dr. M. cured five persons with this prescription who 
had long been under other treatment. Strychnia, in appropriate 
doses, will answer quite as well. 

The following case presents several points of interest, in which 
it is probable that paralysis was more extensively operative in 
the system than might be inferred by some who peruse the nar- 
rative : — A young man, aged twenty-one, after long-continued 
gastro-intestinal suffering, was seized with paralysis of the lower 
extremities, diarrhoea, profuse discharge of urine. The nitrate 
of strychnia was administered in doses of a tenth of a grain, and 
at the expiration of the fourth day of its employment there was 
some motion of the limbs perceptible, and by the time six grains 
were consumed, the paralysis and diabetes had wholly disap- 
peared. (See G-azette des Hdpitaux, 1843.) 

Chorea has been repeatedly cured by strychnia. Thirteen 
patients were treated by this medicine, of which number ten re- 
covered. A grain was incorporated with three and a half ounces 
of syrup, and two and a half drachms of the mixture were given 
daily, in three doses, an increase of a drachm and a quarter be- 
ing made every day, until itching of the scalp and some muscular 
stiffness were obvious. By persevering for a month in the treat- 
ment, the results were gained as above stated. (See American 
Journal of Medical Sciences, 1847.) The same journal for 
1844 reports some cases successfully managed by the strychnia, 
given long enough to induce tetanic spasms ; and in the number 
for April, 1846, a case of chorea is reported as having been 
cured by an overdose. 

In the London Lancet for September, 1845, Dr. Ross reports 
decided success with strychnia in the treatment of chorea, as we 
learn by the following remarks : — 

"The first occasion on which I made trial of the remedy in 
this disease was in the beginning of 1839, in the case of a deli- 
cate girl of twelve or thirteen years of age, who came under my 
care as an hospital patient, with many of the eccentric symptoms 
of this singular disease most distinctly marked. From having 



770 USES OF STRYCHNIA. 

been very expert with her needle, she was rendered incapable of 
using it, and her attempts to thread it were almost ludicrous. I 
prescribed for her the eighth or tenth of a grain of the alkaloid, 
to be taken twice a day. On the second or third day of the 
treatment, through a mistake of the nurse, she had an overdose 
of the medicine, which produced more violent effects than I in- 
tended, viz., convulsive twitches, which, however, quickly sub- 
sided on the medicine being intermitted, and with them all symp- 
toms of the disease. In a day or two after this I saw her thread 
a fine needle with a hand perfectly steady, and she was dismissed 
cured at the end of a week. I saw her more than a year after- 
ward ; she was quite well, much improved in appearance, con- 
siderably grown, and had had no return of chorea. I ought to 
mention that she first came under my care after having been al- 
ready some weeks in the hospital, under the care of my esteemed 
predecessor, Dr. Bayne, whose treatment of her was continued, 
without any improvement in her symptoms until she commenced 
the use of the strychnia. 

"My next case was a girl of the same age and constitution, 
who came under my care as an hospital patient about the same 
period. In her case I adopted the same treatment. No violent 
effects were produced by the remedy, and after a few days' treat- 
ment the symptoms of chorea began gradually to disappear, and 
she was also dismissed cured at the end of a fortnight. 

" I cannot speak so favorably of the effects of strychnia in 
some cases of paralysis in which I have considered myself war- 
ranted in trying its use, and in which class of diseases, under 
certain circumstances, its advantages have been favorably recog- 
nized by some authors ; but in chorea, in the limited number of 
cases in which I have given it a trial, I have been much satisfied 
with the result." 

M. Trousseau treated chorea by the use of the sulphate of strych- 
nia made into a syrup. Four-fifths of a grain were incorporated 
with three ounces of simple syrup, and six teaspoonfuls given 
daily to children from six to twelve years old. The doses were 
increased or diminished according to the effects induced ; among 
which were rigidity of the jaws, neck, and limbs. Three out of 
four children so treated were soon cured, and the fourth was re- 
covering rapidly. 

See L' Union Medicate for June, 1849, and Banking s Ab- 
stract, No. x. p. 41. 

A highly interesting case of the cure of tic douloureux by 
doses of strychnia, usually regarded as poisonous, is reported in 
Braithwaite, part xvii. page 289. The patient had been accus- 
tomed to large doses of muriate of morphia for the relief of his 
sufferings, and took, one day, three and a half grains of a pow- 






USES OF STRYCHNIA. 771 

der just purchased for the same end, and went out upon his 
ordinary business. In a very little "while he felt a disagreeable 
numbness in his legs, increasing rapidly, so as almost to disable 
him. On reaching home he felt better and went to bed, about 
five hours after he took the medicine. Just as he was going to 
bed, in the hope of getting a good night's rest, he took a second 
dose of the same powder as that swallowed early in the day. In 
less than ten minutes violent tetanic spasms came on, affecting 
the legs and respiratory muscles almost to suffocation. The 
spasms followed in close succession and with increasing severity. 
The man continued perfectly conscious, although his senses 
seemed to be invested with unwonted sensibility. 

After a while the paroxysms began to diminish in violence and 
number ; and when it was imagined that the case was about to 
terminate, the symptoms were suddenly renewed with great vio- 
lence. In a short time, however, the aspect changed for the 
better, and at the end of thirteen hours all the symptoms had 
disappeared. The most remarkable feature in the history is that 
the man never after this disaster had an attack of his tic doulou- 
reux. The medical treatment of the poisonous action of the 
strychnia is not stated, but it is added that a quantity of the 
medicine had been taken equal to about three ounces of nux 
vomica, one of the largest portions ever swallowed without a 
fatal issue. 

The above detail is an apt illustration of the doctrine set forth 
in other parts of this work, called the antagonism of poison and 
disease. On no other principle can we account for the failure of 
so much strychnia to destroy life. 

In L' Union Medicale for 1840, Dr. Homolle reports success 
in the -reduction of strangulated hernia with exceedingly minute 
doses of strychnia. He supposes it to act as it does in consti- 
pation from paralysis, by augmenting the peristaltic action, or 
by correcting irregular action. Instead of the hundredth part 
of a grain, we should suppose a tenth of a grain might be safely 
given. 

It is probable the known effect of strychnia in paralytic 
patients — viz., its induction of tetanic spasms — led to its employ- 
ment in tetanus. Dr. Fell reports seven cases of traumatic 
tetanus cured by doses of a sixteenth and a quarter of a grain 
continued so as to induce decided twitching. (See Neiv YorTc 
Journal of Medicine and Surgery for Nov. 1846.) In the Janu- 
ary number of the same work for 1847, an article may be found 
the design of which is to prove the efficacy of strychnia in idio- 
pathic tetanus. 

Dr. Brainard, of Chicago, Illinois, gave strychnia for the cure 
of obstinate intermittents, with considerable success, in doses of 



772 POISON OF STRYCHNIA. 

an eighth of a grain three times a day, in form of pill. (See 
Indiana Medical Journal for July, 1847.) 

A German physician, M. Frisch, found that cases of ague and 
fever, in robust persons, not cured by the sulphate of quinine 
alone, were curable by the addition of strychnia or nux vomica. 
He gave from six to ten grains of the nux, with two ounces of 
cinchona, or twelve grains of sulphate of quinine, in the inter- 
mission. The same physician declares that no medicine is so 
efficacious in that form of chronic diarrhoea kept up by subacute 
inflammation of the villous coat of the intestines, and marked by 
viscid mucus secretions and tenesmus, as the nux vomica. He 
combines it with small doses of ammonia and mucilaginous 
drinks. Dysentery often depends partly on a similar cause, and 
sometimes on lesion of the nervous filaments of the lining coat 
of the colon ; in both cases strychnia has been useful in the ad- 
vanced stage. 

Excessive gastric irritahility has been promptly relieved by 
minute doses of strychnia. The derangement may be so pro- 
tracted as to induce deep innervation of the stomach, and then 
the remedy may be very appropriate. (See Lon. Lancet, Nov. 
1846.) 

Dr. F. E. Wilkinson, in the Lancet for Dec. 1853, speaks 
favorably of strychnia in neuralgia, ague, dyspepsia, epilepsy, 
&c. He employed the liquor of strychnia, made by adding two 
grains to an ounce of phosphoric acid, which is a prompt solvent. 
It adds, also, to the powers of strychnia over the brain and 
nervous system. It makes, in fact, a phosphate of strychnia. 
After attending duly to the secretions he gave five drops of the 
solution (as a general rule) three or four times a day. — Braiih- 
waite, part xxix. p. 54. 

The poisonous action of this article claims some particular 
notice. When a really poisonous dose has been swallowed, the 
fatal consequences seem to depend partly on exhaustion of the 
heart's irritability, and partly on asphyxia. If it actually 
poisons, the first effect is a tremor, followed by stupor and a 
sense of intoxication, after which there are symptoms of tetanus, 
rigidity of the muscles of the neck, even locked jaw, severe pain 
at the lower end of the sternum, violent spasmodic contractions 
of the intercostal and lumbar muscles, and those of the whole 
spine, inducing opisthotonos and laborious respiration, ending in 
complete asphyxia and death. 

The first effort of the physician in such cases is to dislodge the 
offending cause, and the next is to destroy the virulence of the 
action already induced. The stomach-pump or a prompt emetic 
should be resorted to instantly; and, after these have accom- 
plished the desired end, tincture of iodine should be given to 



POISON OF STRYCHNIA. 773 

neutralize the poison. This antidote was first suggested by M. 
Donne, who found that ioduret of starch could be given, in doses 
of two and a half grains, to a dog with impunity, whereas half 
a grain of pure strychnia would kill the same dog. He therefore 
tried iodine as a counter-poison, and with success. He gave the 
tincture to dogs after a grain of strychnia had been swallowed. 
In seven cases only one resisted the antidote, and in that the 
antidote was not given until ten minutes after the poison had been 
taken. 

Tannin is spoken of favorably as an antidote, in the British 
and Foreign Medical Review, 1842 ; it is stated that five ounces 
of decoction of galls precipitated the strychnia from two grains 
of the nitrate so as to render it inert. An insoluble tannate was 
formed. 

The following case presents the largest quantity of strychnia 
on record from which recovery followed. A drunken fellow in a 
moment of high intoxication took a drachm dissolved in spirits. 
All the usual spasmodic effects were induced. The treatment is 
not stated, further than the giving of an emetic. There can be 
no doubt that the intoxication prevented the fatal operation of 
the poison. — London Medical Gazette. 

A young man, aged seventeen, in a fit of low spirits, took two 
scruples, and was speedily seized with great anxiety and agita- 
tion, which are often the first products of its operation. He sent 
for medical aid, and in a quarter of an hour an emetic was ad- 
ministered, but with very trifling effect. The patient now lay 
stiff on his back, with his head bent backward, his lower ex- 
tremities rigid, visage pale and haggard, pulse quick and con- 
tracted, and obvious signs of trismus. The latter increased 
rapidly, and the spasms extended to the muscles of the chest. 
Strong emetic doses gave rise to slight vomitive efforts ; tincture 
of iodine and morphine were administered, but without benefit. 
The whole body was next seized with tetanic spasms, and suffo- 
cation was extreme. This state, with some variations, continued 
until death, which occurred an hour and a half after the poison 
was swallowed. The post-mortem examination was not at all 
satisfactory as to the modus operandi of the poison. 

The Edinburgh and London Surgical Journal for December, 
1845, furnishes the following interesting but fatal case of poison- 
ing by less than one grain of strychnia : — 

"Agnes French, aged thirteen, September 27, 1845, has been 
in this house since the 16th instant, for eczema capitis, which is 
now nearly well. 

"About half past five, p.m., swallowed three strychnia pills, 
which belonged to a paralytic patient in the same ward. Each 
pill contained a quarter-grain of strychnia. She has been occa- 



774 DEATH FKOM STKYCHNIA. 

sionally in the habit of taking medicines belonging to other 
patients. Twenty minutes after taking the pills she said she felt 
a strange sensation in her head, and became almost immediately 
convulsed. The clerk was called, and visited her without loss of 
time. The following was her state : — The arms were found ex- 
tended and rigid, as also were all the muscles of her body, which 
was bent backward at a considerable curve. Pupils were natural. 
Pulse was obscured from the rigidity of the muscles, but impulse 
of the heart was strong. Face was much flushed and lips livid. 
Breathing rapid and difficult, but larynx quite free ; spasms of 
diaphragm very marked. Every few minutes she had a fit of 
general convulsions. The mind was quite entire, and great fear 
and anxiety for relief were expressed. 

" The cause at first being unknown, six ounces of blood were 
abstracted from the temporal artery. Cold lotions were applied 
to the head, and sinapisms to the extremities. Ten minutes after 
the symptoms began the owner of the pills told the cause, when 
a scruple of zinc was immediately given, and large draughts of 
warm water, which were eagerly swallowed by the patient. ISTo 
vomiting, however, was induced for about a quarter of an hour, 
although the fauces were tickled with a feather ; and when the 
emetic operated it acted very sparingly. All this time the 
opisthotonos and universal muscular twitching had continued 
most violent ; but now, during one of the ineffectual attempts to 
vomit, the rigidity of the muscles suddenly relaxed, and the 
spasmodic contractions ceased. The heart's impulse, previously 
strong, could not now be felt, and respiration was for the time 
extinct. Her face, which, from the commencement of the 
attack, had continued deeply flushed, became gradually pale, 
from above downward ; her lips remaining livid. She was laid 
down, and seemed to recover slightly ; her chest heaved slowly, 
and her heart beat feebly and at long intervals. The flush also 
somewhat returned to the face ; but, with the exception of a few 
twitches, she had no recurrence of the spasms. The pupils were 
now dilated, the eyes fixed and turned upward. The stomach- 
pump was suggested and immediately applied, but without any 
good effect. In a short time the respiration again ceased, and 
the heart could no longer be felt. The flush, which had been but 
slight, again descended and disappeared on the neck. Artificial 
respiration and galvanism to the phrenic nerve were now tried in 
vain. The patient was dead. Death took place at three-quarters 
past six, P.M., little more than an hour after the poison had been 
swallowed, and in about three-quarters of an hour after -it had 
produced its physiological effect. 

"Autopsy forty -four hours after death. Face placid; abdo- 
men tympanitic; much lividity of depending parts. Post-mortem 



ANTIDOTES TO STRYCHNIA. 775 

rigidity of body in general moderate, but fingers and thumbs 
very livid, half-flexed, firm, and somewhat elastic. Integuments 
of scalp bled freely on being cut. Brain and its membranes 
quite natural, excepting turgescence of velum interpositum and 
choroid plexus. Spinal cord healthy ; its investing membranes 
rather vascular. Lungs much congested with venous blood. 
Muscles of the heart quite stiff. The right ventricle was flat- 
tened into a sharp edge, and was quite empty. The left ventricle 
was also collapsed and empty. The auricles were in a similar 
condition. The stomach contained a half-digested meal. Its 
mucous lining was pale and natural. Other viscera normal." 

The probability that iodine was antidotal to strychnia was 
shown by the experiments of Dr. Buchanan with the ioduret of 
starch. By reference to the article Iodine, it will be seen that 
seventy-two grains were administered, without any sort of injury, 
at a single dose. 

Dr. Pidduck gives a very interesting case to show that camphor 
is an effectual antidote for the poison of strychnia. An intem- 
perate man, subject to rheumatic gout, took by mistake some 
strychnia powders, in preparing which the druggist erred by 
dividing into six in place of sixteen papers. Two doses induced 
all the worst symptoms of poisoning by strychnia, for the relief 
of which a camphor mixture was ordered, consisting of twenty 
grains in six ounces of almond emulsion, one-fourth to be taken 
every two hours. The first dose allayed the convulsions so effec- 
tually that there was no need of a repetition. — Braithwaite, part 
xxvii. page 326. 

Another successful recovery is reported by Dr. Tewkesburry, 
of Portland, Maine, viz. : — A boy was seized with convulsions 
after eating a biscuit containing one grain and a half, for the 
purpose of killing rats. The spasms were so severe that imme- 
diate death seemed inevitable, though all the usual remedies were 
resorted to. Camphor could not be introduced into the stomach 
on account of the locked jaw. Strong injections, therefore, of 
camphor were used, and the body immersed in a camphor bath, 
and in a few hours the boy was comparatively well. 

Dr. Shaw, of Texas, states that he has found sweet oil, drank 
freely, a successful antidote to strychnine in two cases, — the oil 
poured down without reference to vomiting or sickness. 

Those persons who desire to study the most important features 
of alleged strychnine-poisoning should read with care the full 
account of the trial of Dr. Palmer, who was executed in London 
in 1855, for the murder of John Parsons Cook. The report is to 
be found in the London Lancet for July, 1856, and presents the 
fullest scientific testimony ever given on the subject of poisoning 
by strychnia. No student should neglect to study this report 



776 SULPHUR. 

patiently and thoroughly. Not a little of the testimony was out- 
rageously contradictory, and it is abundantly plain that the cul- 
prit knew far more about strychnia than half the witnesses 
developed on the stand. 

The largest quantity of strychnia ever swallowed without a 
fatal issue is one drachm and a half, or ninety grains. It was 
put into a half-pint of gin, the whole of which was drank without 
suspicion that strychnia was in it at all. The dose sat heavily 
on the man's stomach, made him faint, and finally obliged him to 
take an emetic, at the expiration of four hours and a half, to get 
relief. The person who played this game was tried for an attempt 
to poison, and was sentenced to seven years imprisonment. So 
says the Vermont Caledonian, in July, 1857. We suppose the 
stimulus of the gin defeated the poisonous intent, and the case 
was one of compound poisoning. 

Marshall Hall says the treatment of strychnia poisoning, 
according to his philosophy, resolves itself into the following 
points : — 1st. To get rid of the poison by evacuating the sto- 
mach. If emetics fail in this, then tickle the throat with a fea- 
ther, the patient lying on his face. 2d. Tracheotomy. 3d. The 
ready method, by means of which respiration is reproduced by 
alternate pronation and rotation of the body. — London Lancet, 
February, 1857. 

We close this article with an account of Marchand's test for 
strychnia, which is regarded as a very delicate one. It consists 
in pouring on the strychnia, or mixture containing it, a few drops 
of strong sulphuric acid mixed with one per cent, of nitric acid, 
and then adding a small quantity of peroxide of lead, when 
immediately a fine violet color is produced. The experiment 
succeeds best when the mixture is made in a watch-glass, care 
being taken that the quantity of peroxide be extremely small ; 
and then, on mixing with a glass rod, the color makes its appear- 
ance in streaks. 

Sulphur. — This very simple and neglected article is very 
abundant in nature. The late Professor Physick used to say, 
" If sulphur were a dollar a pound, it would be a very popular 
medicine with the medical profession." Roll sulphur is obtained 
chiefly by roasting the sulphuret of copper. It is collected in 
chambers of brick work, through which the fumes of the heated 
ore are made to pass, and the condensed substance is purified 
afterward by fusion. It is cast into moulds, which give us the 
roll or stick sulphur. 

The sublimed sulphur, or floivers of sulphur, are made by 
heating roll sulphur to 500° or 600°, when it rises rapidly into 
vapor and is condensed in proper receptacles. The collected mass 
should then be well washed several times with pure water, till the 



SULPHUR PILLS. 777 

fluid passes tasteless. In the process of sublimation some sul- 
phurous acid is formed, which would induce griping pains if not 
completely washed out ; and whenever the use of the flowers of 
sulphur occasion this accident in children, it may be inferred that 
the medicine has not been sufficiently washed. 

The only medicinal use of the roll sulphur with which I am 
acquainted is in the form of sulphur tea, as it has been called by 
old rheumatic persons, who profess to have been cured or greatly 
relieved by it. They macerate a pound of the roll, broken into 
small pieces, in a gallon of boiling water, and drink the fluid 
while hot, in wineglass doses, five or six times a day. In winter 
the vessel containing this tea is allowed to remain on the stove, 
and it is frequently shaken. No one can fail to perceive that the 
diaphoretic action set up depends in part on the augmented tem- 
perature of the dose. I knew an old gentleman of wealth and 
respectability, who assured me that he was cured by this simple 
medicine. Another declared his decided conviction that the mere 
act of carrying roll sulphur in his pocket constantly warded off 
rheumatic seizures. He supposed there was some sort of elec- 
trical agency developed in his case. 

The flowers of sulphur have also been employed in rheumatism, 
A teaspoonful in a small cup of milk, taken at bedtime for a 
week, is affirmed to be one of the best remedies that can be em- 
ployed for old and obstinate rheumatic pains, cramps of the legs, 
&c. The quack medicine called the Chelsea pensioner, so famous 
as a rheumatic medicine, was composed largely of the flowers of 
sulphur. (See Meclico-Chirurgieal Revieiv, 1844.) 

Mixed with equal parts of cremor tartar, the flowers of sul- 
phur make a gentle aperient, and children take it readily. The 
dose is from half a drachm to two drachms, given in molasses, 
and repeated, if need be, twice a day. Professor Physick advised 
this medicine for patients laboring under piles, as best suited to 
that condition, acting, as it does, very gently and yet efficiently. 
If repeated several times, its odor is very perceptible on the per- 
son, and silver coins in the pocket are discolored. These effects 
are the more obvious when there is considerable action on the 
skin at the same time. 

While Asiatic cholera was prevailing, in the summer of 1849, 
a Dr. Bird, residing in the State of Illinois, excited a good deal 
of discussion by reason of his sulphur pills, put forth as a 
remedy for that disease. He connected this medicine with the 
notion that ozone was a chief cause of the epidemic. The affair 
proved to be a sort of nine days wonder, and was soon forgotten. 

We learn from the London Lancet of February, 1850, that 
sulphur was held to be an important remedy for cholera long 
before Dr. Bird's announcement was evolved. The editors make 

50 



778 SULPHUR OINTMENT. 

a brief notice of a pamphlet of forty-seven pages, issued in 1848, 
with the title of Sulphur as a Remedy for Epidemic Cholera, 
They apprise us that this pamphlet is not the first publication of 
the kind, and name another, by Mr. Blacklock, of the Madras 
Medical Establishment, as having been reviewed in a former 
number of the Lancet. Mr. Grove, the author of the pamphlet 
first named, speaks of one hundred and one cases treated by the 
sulphur practice, all having recovered excepting three. His usual 
prescription was thus : — 

R. — Sulph. precip. pur. 
Sodse carbon, aa "^i ; 
Lavend. spt. comp. gij ; 
Aquae, Sjvss. 
Mix, and give one-fourth for a dose. 

The first dose, it is said, almost always relieved the patient, and 
the medicine was repeated every fifteen minutes. It induced a 
rapid determination to the surface, a genial warmth and moisture 
following, the odor of the sulphur being strongly exhaled. In 
some cases this medicine was preceded by a drachm of sulphuric 
ether and half a drachm of laudanum for a dose, to be repeated 
in a few minutes if ejected by vomiting. 

At the time when Dr. Bird's ozonoid sulphur pills were the lion 
of the day, a distinguished infinitesimal of this city is reported 
to have announced the discovery that a pinch of sulphur dropped 
into the boot or shoe would infallibly prevent an attack of cholera. 
How big a pinch, we are not informed; but, to be in keeping 
with the farce of the diminutive system, it should be a sort of 
infinitesimal pinch, we presume. The preventive as well as the 
curative indication bore on its frontlet infallible tokens of incom- 
petency. The prescription taken from the London Lancet has 
the semblance, at least, of common sense in its favor. 

Dr. Fuller, of St. George's Hospital, London, has resorted to 
a novel use of sulphur in the treatment of rheumatism, and espe- 
cially of sciatica. The entire surface is covered with precipitated 
sulphur, and then covered with a flannel bandage. Over this is 
put oiled silk or gutta percha, which not only increases the 
warmth and confines the vapor of the sulphur, but obviates the 
unpleasant odor of the remedy. The dressings are to be kept 
on night and day. The sulphur is freely absorbed, as the breath, 
urine, the discharges from the bowels and the skin, fully prove. 

Dr. 0' Conner, of the Royal Free Hospital, gives his testimony 
in favor of the same practice, and cites cases in proof. (See 
Medical Times and Cazette, January, 1857 ; also London Lan- 
cet, February 21, 1857.) 

Sulphur has for a long time been a popular medicine in the 
treatment of itch. It is given internally to keep the bowels 



SULPHUR OINTMENT. 779 

loose and at the same time to affect the skin favorably, while the 
ointment of sulphur is applied to the surface. Three ounces of 
the flowers are well rubbed with half a pound of fresh lard, or 
melted with it, so as to get a well-formed cerate or ointment, 
which should be rubbed into the skin at bedtime. It is proper 
to say that the failures of this treatment are often owing to a 
filthy condition of the skin ; and it is, therefore, very important 
to wash the whole body with soapsuds before the ointment is 
applied. The same ablution should be made in the morning, 
before dressing. Those who are particularly nice prefer the fol- 
lowing ointment : — 

R. — Flor. sulph. ^i ; 
Ung. sperm, ^viij ; 
01. lavend. 
01. lemon, aa ^i. 

Mix these articles very thoroughly, the mixture to be rubbed as before 
directed. 

The following ointment has been long employed in hospitals, to 
kill vermin : — 

R. — Flor. sulph. flbss; 

Pulv. helleb. alb. ^ij ; 
Nit. pot. gi ; 
Sap. moll. Ibss ; 
Adip. suill. Ibiss. 
Mix. 

During the application of this ointment, the bowels are to be 
sufficiently acted on by the flowers of sulphur internally admi- 
nistered. 

Some half-dozen writers abroad have told us a good deal about 
the rapid cure of itch by baths and sulphur ointment, &c. &c. 
One of the most sanguine has arrived at a sort of mathematical 
certainty, by assuring the public that he cures this troublesome 
thing in two hours. Now all this is mere professional gas ; for 
it is absolutely impossible to attain to certainty in a point like 
this. We heard of a teacher who used to tell his class that a 
chill (in common ague) lasted sometimes a minute and a quarter 
by the watch ; but nobody felt the wiser for that announcement. 
So of the cure of itch in two hours. 

Keep the bowels freely open, abstain from animal food, keep 
the whole surface clean by repeated ablution, bathing, soap, chlo- 
ride of lime, &c. &c, and this disease will be certainly cleared 
out of the system in a reasonable time, and that is all a reason- 
able patient ought to expect. 

Sulphur ointment has been resorted to be Dr. Midaveine as a 
substitute for mercurial ointment, to prevent the pitting of small- 
pox. His mixture is from a drachm and a half to two drachms 
of the sulphur to an ounce of lard. He employs a weaker oint- 



780 SULPHURET OF POTASH. 

ment for 2 varioloid than for small-pox. The surface is to be 
rubbed three times a day, as soon as possible after the eruption 
appears. The pustules shrivel up and dry very speedily. The 
patient is soon better, the appetite improves, and he soon gets 
well. — Edinburgh Medical and Surgical Journal, 1841. 

The sulphur vapor bath has been very much employed, and 
successfully, too, in the treatment of various cutaneous diseases 
and rheumatic affections. It induces most copious perspiration, 
affecting the exhalants most powerfully. The patient, entirely 
naked, is placed in a tight box, having his head out and his neck 
so guarded that the vapors cannot reach his nostrils. The vapors 
are conveyed from an adjacent vessel, in which the sulphur is 
heated by means of a tube that perforates the box. The man is 
in an atmosphere or bath of warm sulphureous vapors. Very 
soon the perspiration starts, and a flood of sweat rolls out, in- 
ducing universal relaxation. From a quarter to half an hour 
suffices to make the most decrepit man experience great relief. 
Although he could not enter the box without help, he can now 
move about without discomfort. Several repetitions of this 
bath have completely cured rheumatics and persons affected 
with itch and other skin diseases. In all these cases it is de- 
sirable to keep the bowels under the influence of the flowers of 
sulphur. 

In psoriasis palmaris, a very troublesome affection of the palm 
of the hand, in the nature of common tetter, and to which shoe- 
makers, braziers, silversmiths, and others are liable whose work 
irritates the palm very often, the daily use of sulphur ointment and 
sulphur fumigation has been found very salutary by Dr. Burgess 
and others. (See his Eruptions on the Face, &c. &c, p. 229.) 

Sulphuret of potash. Liver of sulphur — hepar sulphuris. — 
Made by mixing an ounce of washed sulphur and two ounces of 
carbonate of potash and placing the' mixture in a covered cruci- 
ble over a fire until union is effected. Owing to decomposition, 
the product is sulphate of potash, sulphuret of potash, and excess 
of sulphur. The sulphuret is of a dirty white color, inclining to 
an olive-green, having a slightly sulphurous smell, a nauseous, 
alkaline, and bitter taste. Diluted muriatic acid added to it 
gives a copious evolution of sulphureted hydrogen gas. 

Dr. Carusi, an Italian practitioner, has employed the sulphuret 
in asthma. Tartar-emetic ointment to the chest had been un- 
availing, and the patient was cured by this medicine. Sixteen 
grains were made into paste with honey, and divided into four 
portions, one of which was given three times a day. It is stated 
that after the exhibition of the last dose the disease ceased and 
the cure was complete. The asthma was probably spasmodic, 
and yet we can hardly believe that the cure depended simply on 



SULPHURET OF CARBON. 781 

so small a quantity of the sulphuret. We are not toldbwhether 
the medicine induced nausea or not, though probably it did so. 

Sulphuret of potash has long been employed as a lotion for 
cutaneous affections, as tetter, itch, tinea capitis, &c. The pre- 
scription generally relied on is as follows : — 

R.— Sulphur, pot. ^iij; 
Sap. dur. gij; 
Aq. rosar. ^vii. 

Dissolve the solids in the rose-water, and keep the solution in 
a tight vessel ; to be used as a wash at least three times a day. 

The sulphureous bath of Baudelocque, so highly praised in the 
treatment of chorea, is made thus : — 

R.— Sulphur, pot. gij; 
Aquae, lbs. 100. 

Dissolve the sulphuret, and add to it a solution of white glue 
in ten pounds of boiling water. The bath is to be used daily, a 
generous diet being allowed all the while. Several cases are 
cited in which the treatment was successful in from ten to twenty 
days. (See VillaroVs Repertoire de Clinique.) 

Sulphuret of carbon, though very offensive, has been employed 
medicinally. It is a transparent, colorless liquid, discovered in 
1796. It is, properly speaking, a bi-sulphuret, and is prepared 
by passing the vapors of sulphur over red-hot charcoal in porce- 
lain tubes. The vapors of both substances unite and are con- 
densed. It is kept in a very few shops, and is not much known. 
It is a complete and rapid solvent of camphor, but so speedily 
evaporated as to be of little use in that form. 

Wertzer, and other writers in the French Journal of Phar- 
macy, speak of it in the following terms : — They call it a very 
energetic but diffusible stimulant, causing increased action of the 
heart and arteries, inducing afflux of blood to the cutaneous sur- 
face and genito-urinary apparatus, promoting the catamenial 
flow, being also a diaphoretic. 

On account of its stimulant character,* it cannot be employed 
in acute diseases ; but its diaphoretic property has led to its use 
in chronic rheumatism. The dose is from three to eight drops 
in rice or barley-water, or any syrup or mucilage. Professor 
Otto, of Copenhagen, gave in rheumatism and gout four drops 
every two hours of a mixture composed of one part of sulphuret 
of carbon and two of alcohol. At the same time he applied, as 
an embrocation to the painful spots, one part of sulphuret and 
two of sweet oil, well mixed. From eight to fifteen days sufficed 
for successful exhibition. 

When the sulphuret alone is applied to the surface, uncovered, 
its rapid evaporation induces a marked sensation of cold. 



782 SUMBUL — SYRUP. 

Sumbul. — This is certainly not a word that would lead to a 
belief in its medicinal nature. What the origin of the name and 
the thing is we know not, for both seem to be as yet undecided. 
Dr. Todd prescribed it recently in King's College Hospital, in 
a case of epilepsy, and Mr. Savory has employed it as an anti- 
spasmodic. Dr. Granville has spoken of it as a root much em- 
ployed, and with great success, in the Asiatic cholera in Ger- 
many and Russia. The samples first used in London came from 
Hamburg and a town in Russia, and, on comparing them, it 
was ascertained that they resembled calumbo, although evi- 
dently more spongy, and something like huge bungs. They had 
a yellowish-gray tinge, with a whitish appearance in the centre, 
covered with a thin pellicular bark. The root has a very strong 
odor, something like that of musk. Dr. Todd administered a 
tincture of the root in ten-drop doses, three times a day, and 
the lad had no return of fit after its use, although previously 
the fits occurred once or twice a week. The botanical origin of 
the root is yet unknown. — Lond. Lancet, June, 1850. 

Suppository. — This is an ancient contrivance to effect an 
evacuation of the lower bowels without a resort to injections or 
medicine by the mouth. It is, in fact, a local irritant applied to 
the mucous membrane of the rectum, and continued long enough 
to induce a discharge. Experienced matrons employ a piece of 
old paper, rolled up just thick enough to pass readily into the 
gut. Soap is more commonly resorted to, alone or combined. 
A piece of common brown soap, moulded into a circular form, 
an inch and a half or two inches long, will answer very well. 
We can readily add to this, if desirable, a little elaterium, or 
jalap, or ipecacuanha, or rhubarb. The end is usually accom- 
plished by these contrivances much sooner than by internal medi- 
cation, and they are more easily managed than injections. 

Syrups. — This term is applied to water or juices highly 
charged with sugar. They serve not only as vehicles for the 
administration of medicines, but also for drinks when properly 
diluted with water. The more perfectly the juice is saturated 
with sugar, the more easily are syrups preserved; but it is im- 
portant also to keep the vessel in a cold place during a warm 
season, to avoid fermentation. 

Compound Syrup of Ipecacuanha. Syrup of Senna and Manna. 

R. — Pulv. ipecac, ^i; ]£. — Fol. sennse, ^iv; 

Alcohol dilut. Oi. Sem. foenic. cont. ,^iss; 

Digest for two weeks, filter, and " anis cont. ^iij ; 

evaporate one-third. Then add Had. zingib. cont. £iss; 

Syr. simp. Oij. Aquae bullient. Oiij. 
Mix, and simmer for half an hour. Digest for four hours, and strain. 

Dose, one or two teaspoonfuls. Then add 



FORMULA FOR SYRUPS. 



783 



Mannse opt. ^vi; 
Sacch. alb. Jxx. 
Mix, and make into syrup by gentle 
simmering over a slow fire. 

Compound Expectorant Syrup. 

R. — Cochlear, armorac. cont. 
Allii sativ. 

Rad. scill. cont. aa ^i; 
Aquae bullient. Oij. 
Digest in a close vessel for half an 
hour, and strain. To the liquor add 
enough sugar to make a syrup by gen- 
tle simmering. 

Orange Syrup. 

R. — Cort. aurant. rec. ^ij; 
Aq. bullient. Oi; 
Sacch. alb. Ibiiss. 
Digest the first two for twelve hours 
in a covered vessel. Pour off the liquor 
and add the sugar. Then simmer on a 
slow fire to make a syrup. 

Mulberry Syrup. 

R. — Succ. mori, Oi; 

Sacch. alb. Ibiiss. 
Mix, and make into a syrup by 
moderate heat. 

Ginger Syrup. 

R. — Rad. zinigib. cont. ^iv; 

Aquse bullient. Oij. 
Boil for at least two hours, and add 
water to compensate for the loss by 
evaporation. Filter, and add 

Sacchar. alb. q. s. to make a 



rich syrup. This will require an addi- 
tional boiling for half an hour. 

Blackberry Syrup. 

R. — Succ. rub. trivial. Oi; 
Sacch. alb. ibiiss. 

Mix, and make into syrup with mode- 
rate heat. 

Pure Lemon Syrup. 

This is readily made of any quantity 
of pure strained lemon-juice, to which 
enough sugar is added to make a rich 
syrup by boiling for the space of half 
an hour. 

Coze's Hive Syrup. 

Take of bruised seneka snakeroot 
and squills, each half a pound; of 
water eight pounds, and boil over a 
slow fire till half the water is con- 
sumed. Strain, and add four pounds of 
pure honey. Boil down to six pounds, 
and add sixteen grains of tartar emetic 
for every pound of the syrup, or one 
grain to the ounce. The dose is from 
ten drops to a teaspoonful for children 
from six months to two years old, to be 
repeated as occasion may demand. 

Syrup of Wild Cherry Bark. 

Make as strong a decoction as possi- 
ble of the fresh inner bark of the wild 
cherry when the berries are nearly 
ripe. Make it into a syrup with white 
sugar over a slow fire. 



System, State of the. — We introduce this phrase here 
because of its intimate relation to all remedial and preventive 
treatment. No medicine has ever yet been administered under 
a better philosophy than that of quackery, whose action has not 
been governed, in some sense, by a proper appreciation of the 
state of the system at the time of its exhibition. To give a dose, 
to advise a blister or the lancet, simply because the name by 
which the disease has been christened calls for the one or the 
other, is idolatry of nosology as stupid as the jugglery of pow- 
wowing. It is precisely on a level with the newspaper-certificate- 
of-cure-philosophy that has so long disgraced our public press. 
And yet it is the basis of a very large portion of the practice of 
many men who are regular graduates of medical schools, and who 



784 STATE OF THE SYSTEM. 

talk of their experience with as much confidence as even Syden- 
ham could evince were he now living. 

Nor is this all. There are some persons, called doctors, and 
who really seem to be conscious of powers to teach, who deny 
the force or propriety of the phrase state of the system. Possibly 
they do not comprehend its practical bearings, and in that case, 
if ignorance be no crime, they are not censurable. 

For the benefit of some who are honestly solicitous on this im- 
portant point we shall give an illustration or two. A patient is 
ill and has been so for a week. You are requested to see him 
as consulting physician. The pulse is very small but tense, the 
respiration very much embarrassed; there is severe pain in the 
side, and there are also symptoms of biliary derangement. The 
attending physician applied a few leeches four or five days ago, 
somewhere on the chest, with a dose of calomel and Dover's 
powder, and the latter has been repeated several times. The 
consulting physician advises immediate bleeding, directing that 
the finger be kept on the wrist to ascertain the effect on the pulse, 
the orifice to be closed if the pulse sink, and if it rise the blood 
to be permitted to flow to eight or ten ounces. The attending 
physician is astounded. What ! bleed with such a pulse ? He 
has never learned the difference between an oppressed and a 
depressed pulse, and, supposing his patient's pulse to be of the 
latter description, he stands confounded. He insists that the 
consulting physician shall open the vein, and it is done. The 
pulse rises as the blood flows, and it is full and round when eight 
ounces have been abstracted. The patient is obviously relieved, 
and will probably bear to lose eight ounces more in less than 
that number of hours afterward. He finally recovers. It is not 
probable he would have done so if the Dover's powder had been 
continued, or any other stimulant treatment based on a depressed 
pulse, which had no existence. 

A physician who denies, or knows nothing about a blistering 
point, because he is not competent to ascertain the state of the 
system, orders a blister to be applied to a patient, and then de- 
nounces the apothecary because his flies and fly-ointment were 
good for nothing. The plaster was applied to a system highly 
excited, and failed to act, or if it acted at all, served to augment 
the excitement, and thus did harm. This is not fancy. I saw 
precisely the thing here described, and the actor was a man who 
afterward occupied a chair in one of the oldest schools in Ame- 
rica ; and the flies denounced as worthless were of the best qual- 
ity, as I knew well by frequent orders for blisters sent to the 
same shop and made from the same parcel. If his blisters had 
come in contact with a system properly reduced, vesication would 



POWERS OF TANSY. 785 

have ensued just as certainly as it had followed the action of the 
same flies a hundred times. Where, then, was the fault ? 

The same principle applies to the exhibition of emetics for the 
relief of croup with high febrile excitement. "Emetics are 
good for croup, and croup is croup." This is precisely the lan- 
guage of the practice of not a few. They give dose after dose 
of tartar emetic or ipecacuanha, or both, and yet the patient is 
not vomited. At length the warm-bath or the lancet is resorted 
to, and presently comes on vomiting that is almost indomitable, 
and sometimes as terrible as croup itself. If the lancet, or even 
the warm-bath, had been employed at first, a single close of the 
emetic would probably have been efficient. 

The doctrine is specially applicable to the varying character 
of epidemics. A professor once published an elaborate essay on 
scarlatina, and denounced every man as a poor practitioner who 
could not cure every case with a few doses of ipecacuanha. The 
same man a few years after lost three of his own children by the 
same disease, in three weeks, and then began to find out that 
even in scarlatina there might be very different states of the sys- 
tem. Sydenham has definitely settled the absolute need of 
studying the variant features of the same disease in different 
seasons, and of adapting remedies to the opposite conditions of 
the system developed by the unseen agency. Let every phy- 
sician who would prescribe understandingly make himself a per- 
petual student of the state of the system. 

Tanacetum. Tansy. — This bitter vegetable, found in all our 
gardens, calls for no description. Everybody knows it by its 
intolerable bitterness and general appearance. I name it be- 
cause it is a good domestic bitter, and would be appreciated if 
imported from Asia at a cost of two dollars per pound. 

Many of the common people esteem it as an excellent tonic, 
especially for feeble women who are liable to abort. Perfect 
rest in a horizontal posture for two or three months, and daily 
use of tansy tea, with occasional doses of elixer of vitriol, have 
saved many females from the dreaded evil, and they have been 
enabled to reach the full term of utero-gestation. In all cases 
where a vegetable bitter tonic is proper, this will answer a good 
purpose. The cold or hot infusion, or the extract, will answer 
very well ; and there is no fear of using too much. 

Besides the tonic powers, some persons regard it as a valu- 
able anthelmintic. How far these powers are distinct may be 
difficult to decide, but I incline to the belief that in many cases 
the vermifuge result depends on the tonic action. The oil of 
tansy is called an emmenagogue, and has been long esteemed by 
females of a certain description as a powerful article to effect 
abortion. An interesting case is given by Dr. Charles T. Hil- 



786 TAPIOCA — DANDELION. 

dreth, in the Boston Medical and Surgical Journal, of a female 
killed by half an ounce of this oil. She was pregnant, and took 
the oil to promote the evacuation of the uterus ; but the spasms 
induced were so severe that she died in about two hours. On 
dissection, a strong odor of tansy was perceptible, the blood was 
dark and thick, but the stomach and intestines were healthy. 

More recently, a case was reported in the New York Courier, 
in which a half-ounce of the oil was taken by a colored female 
servant girl. Immediately the most dreadful paroxysms came 
on, and although suitable remedies were employed, she died in 
less than an hour. 

Other cases have been reported in different places, and the oil 
has sometimes been swallowed in mistake, with fatal results. 

In all cases of poisoning by this oil, the stomach-pump should 
be employed instantly, or some active emetic, to dislodge as 
much of the poison as possible, and counter-irritants should be 
applied to the epigastrium. The same applications may be made 
to the wrists and ankles, giving the patient, at the same time, 
gum-water, flaxseed tea, or slippery elm infusion ; and, if there be 
much pain, a half-grain of sulphate of morphia may be laid on a 
denuded spot on the epigastric region. 

A poultice of tansy has long been held to have considerable 
discutient powers. It can be made by stewing tansy leaves in 
vinegar, or by adding the leaves to the materials for an ordinary 
poultice. 

Tannin. (See Acid, Tannic.) 

Tapioca.— This is the fecula or starch of the root of Jatropha 
manihot. There are two varieties of the plant, one of which, 
called sweet cassava, yields the tapioca, which is sometimes called 
cassava bread. The tapioca can be made of the fresh roots, the 
juice of which is readily squeezed out, and baked into cakes on 
an iron plate. It is also made by beating the roots into a pulp, 
washing this well with cold water, and allowing the fecula to 
subside from the milky fluid which flows from it. Being then 
dried on heated plates, it takes on a granular form. 

The irregular grains of tapioca, of the size of large shot, are 
whitish, hard, and void of smell or taste, having the general 
characteristics of pure starch. It is dietetic and demulcent, and 
prepared for use very much after the manner of sago and arrow- 
root. It makes a good diet for convalescents, and for infants 
about to be weaned. 

The fresh juice of the plant, unchanged by the processes de- 
tailed, is acrid and poisonous. 

Taeaxacum. Leontodon Taraxacum. Dandelion or Pissa- 
bed. — This plant grows in almost every grass lot, more or less, 
and is therefore well known. The leaves are gathered early in 



DIETETIC USES OF TEA. 787 

the spring, and if blanched, taste a good deal like lettuce or 
endive, and are highly prized by many persons. The roasted 
roots are not unlike chicory. The expressed juice of the leaves 
is slightly bitter, aperient, and diuretic. It has been long em- 
ployed in hepatic obstructions, jaundice, dropsy, and some cuta- 
neous affections. 

The extract is made, as other extracts, from a very concen- 
trated decoction. The dose is from ten grains to a drachm. 
Sydenham prized the root and leaves very highly for their diu- 
retic properties, on which account he employed them in dropsy. 
The prevailing notion then existed that the blood was purified 
by the continued use of the vegetable, and such, is the common 
impression now among the people at large, who use it freely in 
the spring as an esculent vegetable. The infusion may be made 
as strong as possible and drank ad libitum. 

Tea Plant. Thea Bohea. Thea Viridis. — What are called 
black and green teas are procured from different species of the 
tea plant. It is not always true that the green color of tea has 
anything to do with the copper plates on which the drying pro- 
cess is carried on. For many years this process was conducted 
on plates of iron, and without any sort of connection with cop- 
per, and yet the tea was green as before. It is probable that the 
diversity in taste and other properties depends not on any pecu- 
liarity of preparation, but on the fact of a different origin. The 
leaves are gathered at three different periods of the year, viz., in 
the middle of February, the beginning of March, and early in 
April. They are gently dried on iron plates until quite shriveled, 
and when cool are packed in boxes of tin to exclude the air. 
In this way they are ready for sale. 

Touching the constant use of tea as an article of food, there 
has been much diversity of sentiment. I have no doubt that 
those who grow up from infancy strangers to both coffee and tea, 
and fed on milk and water in their stead, will have more vigor- 
ous constitutions as a consequence ; and hence it would be well 
so to train all the rising race. Yet it cannot be doubted that 
thousands who use these luxuries in moderation enjoy good health, 
and that some appear to get along pretty well who take them 
to excess. 

Black teas are far less stimulant than green teas, and there- 
fore less injurious by any indirect sedative influence. But they 
are often boiled so long as to develop decided astringent quali- 
ties, and thus may sometimes induce undesirable costiveness. 
This error in their preparation should always be avoided. 

If strong green teas are taken near bedtime, they induce 
wakefulness and a train of unpleasant nervous feelings, which do 
not follow the use of black tea. 



788 MEDICINAL USES OF TEA. 

Some diversity of sentiment obtains in respect of the medi- 
cinal powers of tea. It is called diuretic and sudorific, as well 
as stimulant. These effects may depend in part on the heat of 
the fluid when drank, and partly on the quantity consumed. 
When the mind is depressed, tea often acts as a very pleasant 
and suitable stimulus ; and hence the improved feeling spoken of 
as consequent upon the use of the beverage. There can be no 
doubt, too, that tea is a provocative of good feeling and con- 
versational powers ; and hence we have heard of persons who 
almost, perhaps quite, unconsiously emptied fifteen or twenty 
cups before rising from the table. The conversational and the 
tea-paroxysm obliterated all ideas of the lapse of time as well 
as of the quantity consumed. 

Contrary to what we might expect, draughts of strong tea 
have induced suppression of urine, as we learn from No. 86 of 
the London Medical Repository. On abandoning the use of the 
article, this result was not realized at all. 

The infusion of green tea has long been employed as an anti- 
dote for the poison of tartar emetic, the effect being dependent 
on the tannin of the tea. Dr. Edward Percival, of England, 
announced some time ago that a strong infusion was an excel- 
lent article to overcome coma and stupor. As coffee has been 
employed for the same end, we infer that tannin is the effective 
agent in both cases. 

The infusion of green tea is an excellent wash for the relief 
of subacute ophthalmia. It is exceedingly soothing after general 
or local bleeding ; and the application of the leaves, as a poul- 
tice, is also quite soothing. Dr. James Stuart, formerly of Phila- 
delphia, was partial to the infusion as a gargle, to arrest profuse 
salivation and to subdue the irritation of the mouth and gums. 

Dr. Sutcliffe, in his Medical and Surgical Oases, published 
many years ago, speaks very favorably of the strong infusion of 
green tea as a wash for the cure of leucorrhoea. It was applied 
with a sponge, and this afterward passed up the vagina. 

Tela Aranearum. Spider's Web. — This and even the spider 
itself have been known, as remedies for ague and fever, for cen- 
turies. The web has been highly esteemed for its peculiar ano- 
dyne qualities, in virtue of which it tranquilizes like opium. Its 
application to fresh-cut wounds, for the purpose of arresting the 
bleeding, is an ancient practice, and is supposed to depend in 
part on its anodyne tendency. The dose, when given internally, 
is five or six grains, repeated every third or fourth hour. 

The small silver-headed spider has been given in wheat dough, 
in form of pill, for ague, on ship-board, by an old sea captain, 
for many years. He affirms that it always arrested the disease 
promptly. I received this intelligence from a very respectable 



TURPENTINE. 789 

merchant, who was a passenger in the vessel of the old captain, 
and who was cured by a single spider, as he assured me. 

Terebinthina. Turpentine. — The pinus sylvestris, or Scotch 
fir tree, yields turpentine by natural exudation, or from incisions 
made into the trees through the bark. Most of the trees of the 
pine tribe will do the same. The product is called common tur- 
pentine, which consists of resin and a volatile oil, known in its 
separated or distilled state as oil of turpentine. The Chian, or 
cypress turpentine, is obtained from the pistacia terebinthus. 
The Strasburg turpentine comes from the pinus picea. The 
Venice turpentine is furnished by the pinus larix. All these 
are stimulating diuretics and detergents. They all stimulate the 
primse vise, and prove laxative, but are seldom given internally. 

The terms spirit and oil of turpentine are employed synony- 
mously. To get the pure oil, a pint of the common article and 
four pints of water are mixed, and distillation is cautiously car- 
ried on. The product is the pure oil. This is held to be stimu- 
lant, diuretic, and sudorific, in doses of from ten to twenty drops. 
The following formula has been devised in order to remove the 
unpleasant taste of turpentine : — 

R. — Pulv. g. Arab. 
Aquae, aa gi ; 
Mell. 

01. tereb. aa gv ; 
Carb. magnes. q. s. to make a soft electuary. 

The dose is from thirty-five to one hundred and eighty grains 
in a day, in unleavened bread. (See BelVs Bulletin of Medical 
Science, 1843.) 

Pretty large doses of turpentine have appeared to afford relief 
in chronic rheumatism. It may be added to sugar or honey, or 
made into an emulsion. A drachm, with two drachms of honey 
or an ounce of cinnamon-water, may be taken at one dose. From 
a teaspoon to a tablespoonful will act on the bowels, sometimes 
without irritating the urinary organs, although it will impart a 
violet odor to the urine. These doses are useful not only in 
chronic rheumatism, but in obstinate costiveness ; and if their 
irritant action is dreaded, an ounce of castor oil can be added. 
In cases of obstinate costiveness, the mode by injection is also 
adopted ; an ounce of the turpentine and the yolks of two eggs 
being added to a pint of thin starch, and the whole given in two 
injections, with half an hour between them. 

I regard turpentine as among our best anthelmintics, and 
specially suited to young children, because of the smallness of 
the dose. To a child five years old, we may give five drops on 
sugar, three times a day, increasing the dose by one drop every 
day. Let it be continued four or five days, and intermit, and 



790 MEDICAL USES OF TURPENTINE. 

give a full dose of castor oil After this has fully acted, renew 
the turpentine, and go on with it as before. The small thread- 
worm of children is dislodged by this practice effectually. 

In vols. x. and xiv. of the Edinburgh Medical and Surgical 
Journal are some interesting cases of tapeworm cured by this 
remedy. In one of these, two ounces were taken at a dose, and 
in less than half an hour the man voided three yards of tape- 
worm. Violent pains of the stomach and bowels preceded the 
evacuation. An intemperate man took three ounces at one dose, 
and in a few hours the worm passed, dead. 

Dr. Bellingham, physician to St. Vincent's Hospital, Dublin, 
gives his mode of using turpentine for the cure of tapeworm, in 
the Dublin Medical Press of September, 1842. He does not 
think it necessary to give the large doses which some physicians 
administer. He thinks the result will follow as certainly if the 
system be kept for a longer time under the remedial influence by 
a repetition of moderate doses, and only now and then giving a 
larger dose. When the turpentine does not purge, he adds castor 
oil to gain that end. 

Having employed the turpentine myself for the cure of tape- 
worm, I feel satisfied that the ounce or half-ounce doses are best, 
and that they will sometimes act quite as well if as much castor 
oil be added. The medicine is too unpleasant to admit of long 
continuance, and this is avoided by employing large doses. I 
never witnessed any inconvenience from their use. 

Large as the doses named above may seem, we have an account 
of four ounces swallowed at once by a patient ill of plague. 
The turpentine held in solution a drachm of camphor, and the 
whole was taken in mistake. The mixture had been prepared 
for external use, and, fortunately, it cured the man. It is more 
than probable that this accident led to the use of the medicine 
in yellow fever ■, for the arrest of vomiting and irritability of 
stomach. 

Dr. Copeland found turpentine very useful in malignant typhus, 
in half-ounce doses given in barley-water. The remedy gave 
plentiful evacuations by stool and urine, and before morning the 
patient was decidedly better. In some cases inflammation of the 
bladder and urethra followed, and for several days bloody urine 
was discharged. I have no doubt that simple typhus, with great 
prostration and torpor of the alimentary canal, would be relieved 
by ounce doses, so as to effect the urinary organs as well as the 
bowels and general system. And if the local impression on the 
bladder did not follow these doses, I would give drachm doses 
more frequently. It is important to keep up irritation of the 
bladder for several hours, and so to concentrate morbid action 
there. It is on this principle we cure tetanus with cantharides. 



USES OF TURPENTINE. 791 

Dr. Gilbert King speaks favorably of the use of spirits of tur- 
pentine in low forms of bilious remittent fever, and also in typhus 
fever, such as he saw in Bermuda. 

In diarrhoea, or dysentery occurring in the progress of fever, 
and attended with great exhaustion, some physicians give the 
spirit of turpentine in doses of six to ten drops every two hours, 
on sugar, or with mucilage of gum Arabic. In lieu of the spirit 
of turpentine, the solid white turpentine has answered as well. 
(See Braithwaite, part xx.) 

In obstinate costiveness, apoplexy, and acute hydrocephalus, 
injections of turpentine have done good by evacuating the bowels 
and inviting morbid action to the rectum. From half an ounce 
to two ounces may be added to a common purging clyster, accord- 
ing to the age of the patient. 

Turpentine was among the hundred and one popular remedies 
for ague and fever, thirty years ago, in the vicinity of Philadel- 
phia. I knew a young man who took a gill just as the chill was 
coming on, and he was nearly destroyed by it. For several 
hours he was manifestly deranged, but his ague was not arrested. 

A much more plausible, and certainly a safer use of turpentine, 
is in the form of a liniment to the whole spine. Elsewhere we 
have noticed the good effects of mustard to the spine to prevent 
ague attacks, and we presume the turpentine acts on the same 
principle. M. Aran states, in the Bulletin de Therap., that he 
has deferred ague fits frequently by a liniment composed of oil of 
turpentine three and a half ounces, mixed with one drachm of 
chloroform. Prior to M. Aran's treatment, M. Bellencontre 
employed turpentine in the same way, mixed with laudanum. 
Applied hot and with some friction, the effect would probably be 
more speedily and signally displayed. 

I know a family in which croup has been exceedingly trouble- 
some. Every child had several attacks, and the parent assured 
me that he had learned to arrest the disease most happily by ad- 
ministering from twenty to forty drops on sugar. It is scarcely 
needful to say that the croup must have been the spasmodic or 
non-membranous variety. On the same principle, turpentine is 
frequently salutary in purely spasmodic asthma. 

Turpentine has been highly extolled for its remedial powers in 
puerperal fever. Dr. Brennan, of Dublin, was the first physi- 
cian to employ the medicine in this disease. Dr. Copeland has 
also given it a trial in Queen's Hospital, in doses of half an 
ounce and a whole ounce, which acted on the bowels and seemed 
to exert a good counter-irritant influence. 

Injections of turpentine have been successfully administered 
in amenorrhoea, by Dr. Elliotson. He gave it to a girl aged 
eighteen, who had no menstrual discharge for four months. After 



792 MEDICAL USES OF TURPENTINE. 

a moderate bleeding, he gave half an ounce of turpentine in a pint 
of barley-water every day, as an injection. In a few days the 
catamenia returned, and she was discharged well. Turpentine 
stimulates the rectum powerfully, and the excitement is thence 
carried to the uterus. 

A remarkable case of diabetes associated with phthisis pulmo- 
nalis, and obviously relieved by turpentine, is reported in the 
seventeenth part of Braithwaite' 's Retrospect. The patient had 
diabetes for ten months, and the minimum quantity of urine dis- 
charged was nearly two gallons per day. An alarming haemop- 
tysis supervened, for which turpentine was prescribed. The first 
dose obviously lessened the urinary discharge, and after a few 
doses were taken the urine passed in the natural quantity. 
These changes were supposed to be mere casualties ; but on 
omitting the turpentine, the quantity of urine greatly increased, 
as also the extensive thirst. 

Turpentine is held to possess a decided anti-hemorrhagic pro- 
perty, and even to be able to correct the hemorrhagic diathesis. 
It appears to be well suited to the bleedings of old persons, 
which of course are to be regarded as passive hemorrhages. 
Eight-drop doses have speedily arrested hematuria of long stand- 
ing ; even a single dose sometimes answered this end. (See New 
York Journal of Medicine and Surgery, 1848.) 

Mr. Adair, surgeon at Gibraltar, treated almost all kinds of 
internal hemorrhages with this medicine, with doses of from five 
to fifteen drops given every six hours. 

The Edinburgh Monthly Journal of Medical Science for De- 
cember, 1845, gives the history of two very interesting cases of 
purpura hemorrhagica treated by large doses of turpentine. 
Dr. Neligan states that " It acts as a powerful cathartic, and 
possesses the property of checking hemorrhage depending on an 
atonic state of the smaller blood-vessels, owing probably to its 
powers as a diffusible stimulant. In consequence of those views, 
I employed this remedy in the four cases that afterward came 
under my care while in charge of the district, and they all re- 
covered. I prescribed the oil both in the form of draught and of 
enema; the usual dose for adults being from one ounce to one 
ounce and a half, and for children from two drachms to half an 
ounce, generally in combination with castor oil, to render its 
cathartic action more certain. 

" Since that time I have employed oil of turpentine in every 
case of purpura which has been under my care, and its use has 
been invariably attended with beneficial results." 

In addition to the efficacy of turpentine in purpura hemor- 
rhagic, and in yellow fever, so often epidemic at the Naval 
Hospital of Bermuda, Dr. Laird declares that he has had great 



POISONING BY TURPENTINE. 793 

success with it in jaundice dependent on excessive secretion of 
bile. The usual dose was a drachm every two or three hours. 
Sometimes it was given with nitrous spirit of ether, to promote 
perspiration and avoid strangury. Several cases are detailed, 
but we have stated the substance of the treatment. For further 
particulars, see Braithwaite, part xxx. p. 68. 

The expectorant property of turpentine, has been inferred from 
the effects of twenty-drop doses, given on sugar three times a day, 
in phthisis pulmonalis. It can exert no real agency on this 
disease, and can at best only relieve a symptom. The effect is 
very much like that of naphtha, so recently lauded as a panacea 
for consumption. 

Dr. Moreau, in the American Medical Monthly, January, 1855, 
speaks highly of a bath of turpentine vapor, in catarrhal affec- 
tions, rheumatism, and severe neuralgias. The patient is shut 
in a room into which the vapor is introduced from without, vary- 
ing in temperature from 45° to 102°. It produces copious per- 
spiration, which greatly diminishes the temperature of the body. 

Turpentine is often employed externally, and chiefly for its 
rubefacient action. Applied very hot to the throat by smart 
friction, and a flannel well soaked retained on the surface by 
means of a bandage, turpentine promptly relieves the fauces and 
soft parts of the throat. Hence it is a useful remedy in many 
cases of cynanche tonsillaris. 

It is also resorted to by some persons as a remedy for burns 
and scalds, when it acts by counter-irritation. Rubbed well with 
basilicon ointment it constitutes Kentish's salve or ointment for 
burns, noticed in another place. 

It is stated in the Memoirs of the London Medical Society, 
vol. v., that the vapors of turpentine cured a very obstinate 
ophthalmia of fifteen months' standing. It cannot be that the 
inflammation was of the acute form, as that would most likely 
be aggravated by the remedy. 

A mixture of camphor four parts, and spirits of turpentine 
thirty parts, has been much extolled by M. Groffin as a remedy 
for chilblains, when the parts are swollen, shining, and covered 
with vesicles. It should be applied by gentle friction night and 
morning, the parts having first been well washed with soapsuds. 
(See Braithwaite, part xx.) 

The following turpentine compound has been usefully applied 
to carbuncular affections, sloughy and atonic ulcers, &c. Three 
hundred and forty- two cases of malignant pustule have been 
treated with it since 1837, by Dr. Thielman, of Berlin. The 
compound is made thus : — Mix gi oil of turpentine with the yolk 
of an egg, and add Si spirit of camphor and Bbi chamomile tea. 
Apply the mixture on soft lint covered with oiled silk. At first 

51 



794 THERAPEUTICS. 

the application burns, but the sensation soon passes away. If 
the burning be severe, add more chamomile tea to dilute the 
mixture. 

The late Dr. Joseph Hartshorne, of Philadelphia, was partial 
to a turpentine solution of cantharides, as an application in the 
erysipelas of persons of a relaxed habit, with a tendency to the 
typhoid state. One ounce of powdered flies was boiled in four 
ounces of spirits of turpentine in a glass vessel in a sand-bath. 
The product, diluted with olive oil, was applied to the affected 
parts by means of linen cloths well soaked in it, the application 
being renewed four or five times in twenty-four hours. 

The following case of poisoning by turpentine is sufficiently 
interesting to find a place here : — A child, fourteen months old, 
swallowed four ounces by accident. In two hours after, the pa- 
tient was comatose, pulse 130, eyes injected, pupils dilated, the 
respiration hurried, the bowels painful, and there was great pain 
in urination. Ipecacuanha having been administered soon ex- 
cited vomiting, and this was prolonged by the use of warm water. 
A teaspoonful of spiritus mindereri was given every hour, cold ap- 
plications made to the head, and flannels wrung out of hot water 
laid on the epigastrium. In a few hours there was manifest im- 
provement, and the child passed some worms. , A dose or two of 
castor oil completed the cure. 

Dr. Maund has reported a case of fatal poisoning by turpen- 
tine, in the Grlasgow Medical Journal of April, 1857, as we 
learn from the North American Medico-Chirurgical Review 
(Philadelphia) for September, 1857. He is right in his infer- 
ence, that death is very rare from this cause. The case reported 
by him proves that such a consequence may ensue. The victim 
was an intemperate female, who was seen to swallow the contents 
of a soda-water bottle, supposed by the lookers-on to be whisky 
or gin, but which proved, on subsequent inspection, to have been 
turpentine. At the end of four hours after, she was found dead. 

The probability is that not less than six or eight ounces of 
turpentine were swallowed by this individual, and, for aught we 
know to the contrary, the article may have been drugged, so as 
to be more poisonous. The contents of the stomach were ex- 
amined for strychnine, but none could be detected. 

Therapeutics. — This term is generally held to be synonymous 
with the phrase methodus medendi. It comes from the Greek, 
and imports simply to cure. It is, properly speaking, that de- 
partment of pathology which considers the application of all the 
means and remedies employed to prevent, palliate, or cure. The 
cure of a disease may be said to result from the combined agency 
of nature and the remedies employed for the most part. We are 
aware that the powers of nature alone often bring about very 



THERMIC TREATMENT — TINCTURES. 795 

manifest curative results ; but, generally speaking, we look to 
the additional help of art as necessary. This help may be ar- 
ranged under three heads, viz. : — The right direction of diet and 
regimen, which may be called the hygienic treatment ; that which 
refers to the administration of medicines, externally and inter- 
nally, which is properly styled the medical treatment ; and that 
which demands the use of manual and instrumental operations, 
which is the surgical treatment. 

It will be discovered by the reader that this extensive view 
of therapeutics has been constantly before the author's mind. 
Indeed, he regards this as the most important feature in the 
volume. 

Thermic Treatment. — This is the name given by Dr. Day to 
the practice noticed in another place under the article Firing. 
It is spoken of also as the heated iron. In the London Medical 
Times for August 11, 1849, much evidence is presented of a most 
satisfactory nature touching the efficacy of this remedy. For an 
abstract of the same, see Braithwaite, part xx. p. 54. 

Tinctures. — A solution of the active parts of any medicine 
in an alcoholic menstruum or in acetic acid, may be called a 
tincture. We call the most fashionable fluid preparation of 
colchicum an acetic tincture. The strongest alcohol ordinarily 
found in the shops is required for the solution of resinous mat- 
ters that contain no gum, while diluted alcohol or proof spirit 
will suffice for other articles of which tinctures are commonly 
made. Occasionally some of the others are employed to hold 
substances in solution, and the products are called tinctures, or 
ethereal solutions. 

The substance to be made into a tincture is ordinarily bruised 
or reduced to a coarse powder and submitted to the operation of 
the solvent for one or two weeks, with or without heat, afterward 
strained or filtered through bibulous paper. Not a few of the 
tinctures are directed to be made by displacement, which, how- 
ever, in no sense affects the quality. 

As tinctures made of alcohol or ether are easily evaporated, 
and so wasted, it is necessary to keep them in well-stoppered 
bottles, each being accurately and plainly labeled according to 
its proper title. 

I have taken the trouble to count the number of tinctures 
given in two works of considerable notoriety, and find the one 
to contain the titles of one hundred, the other of one hundred 
and forty, with the modes of preparation. And of all this array, 
I have never, in the course of my professional life, employed 
twenty ; nor do I believe there lives the man in this country who 
thinks of resorting to forty of them. When I say that I have 
never employed twenty, it is not to be understood that my habit 



796 TOMATO. 

was to use anything like that number. When most actively en- 
gaged in practice, the number rarely amounted to ten, and the 
half of these very seldom in the course of a year. 

While in an emergency any form of medicinal administration 
may be proper, or at least may be tolerated, it is not so in ordi- 
nary cases, where we are at liberty to make the wisest selection 
in view of all the circumstances. If a tincture be of such potency 
that the dose will amount only to a few drops, or if it be a little 
larger, but exceedingly offensive, so that no man will be likely to 
fall in love with it for the sake of the alcohol in it, there may be 
some show of propriety in its administration in preference to the 
form of pill, powder, or infusion. But if the dose be so large as 
to gratify the palate and the stomach, in virtue of the alcohol it 
contains, it should never be allowed a place in our list of reme- 
dies. My first teacher of Materia Medica, who fell a martyr to 
over-stimulation, was wont to declare, very emphatically, that 
more than half the drunkards of America were made such by the 
doctors. He uttered precisely what every observant physician 
knew. The thousands of hogsheads of brandy and wine em- 
ployed as the vehicle for the administration of Peruvian bark, 
manufactured inebriates by wholesale ; and in view of the aboli- 
tion of this pernicious practice by the introduction of the sul- 
phate of quinine, we may very justly affirm that its discovery was 
the most valuable ever made in Materia Medica. 

We hold the exhibition of tinctures, when infusions and pow- 
ders and pills will answer equally well as medicinal agents, to be 
a palpable dereliction of duty, excepting the restrictions and 
conditions stated above. We are bound, as guardians of the 
public health and happiness, to discountenance all prescriptions 
that very obviously tend to promote intemperance. We are not 
compelled by any lack of means to resort to even doubtful expe- 
dients, unless in times of great emergency. 

Nor is this all. Some of the tinctures, when given in large 
doses, as a tablespoonful and oft repeated, are palpably incom- 
patible, and have done positive mischief by their stimulating 
quality, when the case in hand required depleting remedies. 
The tinctures of senna, jalap, rhubarb, and the like, so much in 
favor with some physicians, are directly in point. 

Tobacco. (See Nicotiana.) 

Tomato. Solanum Ly coper sicum. Love Apple. — This is a 
variety of the same genus that furnishes our white potato. The 
almost universal agreement touching this article as a part of diet 
is in its favor. Very few persons refuse it ; and as there are 
many modes of preparing it, almost any taste can be accommo- 
dated. It is probably one of the most salubrious vegetables of 
which we partake. 



TONICS — TOUS LES MOIS. 797 

A vigorous effort was made in Ohio, some fifteen years ago, to 
induce the belief that tomato could be substituted for calomel as 
a remedial agent. The vegetable was purchased by cartloads, 
and, as a consequence, its price was enhanced. A considerable 
amount of capital was expended in giving notoriety to the new 
operation, and thousands of boxes of pills were manufactured 
and vended in the West. But when a careful analysis was made, 
it was ascertained that the extract of tomato, so highly praised 
for its alterative qualities, was a fabrication of pill mass from a 
number of ingredients, while the real tomato played either no 
part at all or one of the sheerest insignificance. As a thing of 
course, the cheat being exposed, the discovery went to the tomb 
of all the Capulets. 

Tonics. — This comes from a Greek word, meaning to strengthen. 
It is applied to all such means as increase the tone of the mus- 
cular fibre and impart vigor to the whole system, or to any part 
of it. 

Tonics are not only found in the mineral and vegetable king- 
doms, but equally so in those mental emotions which excite the 
body, as confidence, hope, and any pleasurable amusement. 
While their use is decidedly proper and necessary to elevate the 
system from debility to a sound, healthful state, they are just as 
improper when the system is excited either transiently or more 
permanently above the natural standard. 

Tormentilla. Potentilla Tormentilla. Root of common 
Tormentil. — This is a very ancient remedy, and had consider- 
able reputation with the Greeks. The root is quite knotty, 
tuberous, abounding in radicles, brown on the outside and red 
within, having very little smell, but a strong, astringent taste. 
It contains tannin enough to give it marked astringency, also 
some volatile oil, coloring matter, and gum. It has been re- 
sorted to in the process of tanning. From half a drachm to a 
whole drachm of the powdered root has been given, for an adult 
dose, in diarrhoea and chronic dysentery. In Guy's Hospital 
the decoction of the root has lately been used successfully in 
hemorrhage from the bowels. An ounce or two to a quart of 
boiling water will furnish a decoction of which one or two ounces 
may be given every three hours. 

Tous les mois. — This is the title of a very fine variety of 
fecula, or starch, obtained from the canna coccinea, and some- 
times called canna starch. It is not the same article precisely 
as arrow-root, although apothecaries have sold the latter for the 
former. It does not require the tenth part of preparation, as 
an article of diet, that is bestowed on arrow-root ; and, as I know 
by experience, it is decidedly more pleasant. It is manufactured 



798 TREATMENT — TREPHINING. 

in large quantities in the island of St. Kitts, and can be obtained 
in the best drug stores. 

Treatment. — The use of all our remedies and advice refers 
to treatment; and, in truth, they would seem to be synonymous 
expressions. We speak sometimes of curative and remedial 
treatment; but these are evidently the same in kind, and em- 
brace all measures that tend to restore patients to health. They 
differ, of course, from those appliances called palliative and pre- 
ventive, and which have been noticed under their appropriate 
captions, though briefly. 

The terms empirical and rational are not so well appreciated 
by the profession as are the foregoing, and therefore we notice 
them a little particularly. When do we prescribe empirically, 
and when rationally? Is it ever just and proper to prescribe 
empirically ? 

We reply that all our treatment is empirical, for which we 
cannot give, even to ourselves, a valid reason. A case is ex- 
ceedingly obscure, and, with all the research we can bring to 
bear upon it, the mystery continues. What are we to do ? We 
cannot see our way, and hardly can we feel it. Under such cir- 
cumstances, something must be done. We may fall back on first 
principles ; but still the way is dark, and we must do the best we 
can. Our prescription is made, but it is in the dark. We think, 
on the whole, that it will suit the case, but that is all. 

Now, the difference between this sort of empirical practice and 
that of sheer quackery consists in the settled habit of the latter to 
practice by guess, and in the fact that the regular physician never 
does so but by necessity. Empirical practice is the practice of 
the quack all the while, but it constitutes the exceptions only of 
the regular physician. 

We pursue a rational course when we adapt our means so 
plainly to the end that we feel confident what the result will be. 
We have defined the premises exactly, and feel sure that we are 
right. We are not operating in the dark, but see our way from 
first to last. This is fairly exemplified in all those cases in which 
the diagnosis is easily and certainly made, as in pleurisy, pneu- 
monia, and the like. Comprehending the difficulty precisely, we 
act in the most rational manner in bringing our appliances to 
bear upon it. To do all this in the best practical manner calls 
for a sound, discriminating judgment, fortified by good common 
sense, the whole being based on a well-ordered preliminary and 
collegiate education. These, in happy union, and vigorously 
exercised, constitute the radical difference between the every-day 
empiric and the enlightened, cultivated physician. 

Trephining. — The introduction of a surgical appliance in 
such a work as this may excite some surprise; but regarding it 



TREPHINING. 799 

as I do as a very happy therapeutic means for accomplishing 
an end not always reached by ordinary medical treatment, I 
hold it to be as legitimate an object of attention as calomel or 
opium. I am induced the more to give it a place because the 
compilers of works on the theory and practice of medicine, from 
whatever motive is not material, pass it over almost in silence. 
Some of the most noted standard books do not even name the 
subject, so common is the habit, and so inveterate, too, of 
stereotyping the old matter of centuries gone by, as if it were 
absolutely unimprovable. To such stupid infallibility I will not 
subscribe. 

My object is not merely to draw attention to the ascertained 
value of the trephine as a means of curing epilepsy, but also to 
do justice to American practitioners who have ventured the 
operation and succeeded with it. Introductory to this, however, 
it is proper to say that Aretseus, Themison, Rhodius, La Motte, 
Burserius, and other old writers, speak favorably of this plan of 
treatment, and that Elliotson and other foreigners in later times 
have cured epilepsy by the trephine. All this has long been 
matter of record, and yet unnoticed by most of the recent writers 
and compilers. 

To Professor Benjamin W. Dudley, late of the medical de- 
partment of Transylvania University, in Lexington, Kentucky, 
belongs the credit of introducing this method of cure in this 
country. He supposes, and very correctly, that his repeated 
success has established the following principles, viz., that the 
brain will bear severe mechanical irritation for a great length of 
time without fatal disorganization, and that the use of the tre- 
phine under such circumstances may restore the organ to its 
former healthy condition. 

The first paper from the pen of Professor Dudley has been 
public property for more than twenty years, having appeared in 
the Transylvania Journal of Medicine in February, 1828. The 
first of his reported cases presented itself in 1818, in the person 
of a carpenter, who for nine months had been afflicted with severe 
pains of the upper and posterior portions of the skull. In two 
months after this, he became epileptic, and his convulsive seizures 
were so frequent as to excite apprehensions of speedy death. 
Mercurial treatment was pushed pretty far, but only with the 
effect of making matters worse. 

A careful examination detected two sensible depressions of the 
skull, attended by great sensibility of the integuments, and yet 
these were not referred to any accident or injury. On the 16th 
of April, 1819, two circular pieces of bone were removed from 
the immediate vicinity of the depressed spot, and in three months 



800 EPILEPSY CURED BY TREPHINING. 

after the patient was fully restored to health, having had only 
two very slight attacks after the operation. 

The next case is that of a young man, aged twenty-one, who, 
when only five years old, received a severe blow on the upper 
and middle portion of the left parietal bone. On the ninth day 
after the accident he became apoplectic and paralytic, and finally 
epileptic. The physicians of the country diiferecl as to the real 
nature of the case, and some proposed an operation. Professors 
Physick and Chapman were at length consulted by letter, and 
they discouraged the idea of an operation altogether, advising 
only a very abstemious diet. 

The trephine was applied in this case, and so happily that the 
patient was able to travel from Lexington to his home, a distance 
of five hundred miles, in the month of July, having been restored 
to perfect health. 

The other patients named in this paper were obviously relieved, 
but not known to be cured at the date of the article. 

A successful case is reported by the same gentleman in vol. v. 
of the same journal. The injury which set up the epilepsy was 
a gunshot wound of the head. The fits were so severe as to 
justify the patient in submitting to the operation of trephining, 
which completely restored him to his former state of health. 

In vol. iii. of the same journal is an extract of a letter from 
Dr. Cartwright, of Natchez, furnishing the case of a cotton 
planter who had severe epilepsy, caused by an injury of the 
head. The operation of trephining was done by Dr. Elliott, and 
there was no return of epileptic fits. This case occurred in the 
fall of 1828. 

In the North American Medical and Surgical Journal for 
1826, is a very interesting case, reported by Dr. David L. 
Rogers, of New York. The man, aged forty-six, had been epi- 
leptic for the space of fourteen years, and was fast sinking into 
idiocy. The disease resulted from a severe wound of the anterior 
portion of the skull, and he was trephined over the spot in July, 
1825. Nine months after the operation, the patient was en- 
tirely free of his convulsive attacks ; he had nearly regained his 
memory, and could attend to his ordinary business without in- 
convenience. 

In the American Journal of Medical Sciences for May, 1829, 
we find a report of a case by Dr. James Guild, of Tuscaloosa, 
Alabama, who, from the fact of being a graduate at Lexington, 
Ky., no doubt learned the importance of the treatment from 
Prof. Dudley. This case is the more important because the 
disease had no known connection with any previous injury. No 
mark of depression could be seen, nor was there any reason to 
suppose an injury had been sustained. The man was forty 



EPILEPSY CURED BY THE TREPHINE. 801 

years of age, and had very frequent epileptic attacks. He had 
long suffered severe pain in the left side of the os frontis. The 
trephine was applied on the painful spot, and in thirty days 
after, the patient was discharged, perfectly cured. In view of 
the facts, Dr. G. very properly suggests the probable utility of 
the trephine in many cases of lunacy and incipient idiocy as 
well as in epilepsy. We entertained the same view long before 
we learned that such a sentiment had been advanced by any 
one. In every inveterate case refusing to yield to treatment of 
the usual kind, and likely to progress to a fatal issue, we think 
the trephine applied anywhere on the head may be useful. 
Should it remove a piece of bone with a projecting spicula an 
inch or more long, as has been done, it would no doubt cure the 
patient; and at any rate the removal of one or two pieces of 
bone would relieve the brain from undue tension, and might thus 
do much good to the patient. 

In the days of our pupilage we saw a man in the Philadelphia 
Almshouse very frequently, who had been terribly epileptic for 
many years, and who finally died of the disease. Dissection 
showed a spicula of bone an inch and a half long penetrating 
into the brain, and which was doubtless the occasion of the fits. 
Had the trephine been applied in that spot, the man might have 
been cured. 

As epilepsy depends on various causes which cannot be noticed 
here, it is suggested that the most careful examination be in- 
stituted, and that when all our best endeavors fail to relieve, in 
conformity with the more ordinary practice, a trial be made of 
the trephine. That it will always cure is not pretended, but that 
it will often succeed is certain. 

The most recent and successful use of the trephine for the 
relief of disabilities caused by injury of the head, occurred in the 
Philadelphia College of Medicine. The patient was a female, 
residing in a neighboring county, who was injured by a stroke 
on the head when a child. She had suffered severe pains in the 
head, and had realized frequent inability to articulate, with 
various nervous spells not unlike convulsions. The trephine suc- 
ceeded in giving speedy relief, and her cure was complete. The 
operation was performed in the spring of 1849. 

We may add, without offering any sort of claim to originality, 
that while a pupil we knew a student with a very large head, but 
who was exceedingly dull, and in whose case we often suggested 
that the brain had not room enough for mental development, and 
as a remedy we proposed to trepan him, and by removing part 
of the cranium to allow more ample motion of the contents of 
the skull. This suggestion, wholly disconnected with any know- 



802 ELM — STINGING NETTLE. 

ledge of the actual use of the trephine as above, by the ancients, 
was of course not carried into effect. 

Ulmus. Elm. Ulmus Oampestris. Ulmus Fulva. — These two 
species refer to the common elm and the slippery elm, both of 
which are well known to the people at large. The slimy juice of 
the inner bark of the common elm has long been used in affec- 
tions of the kidneys as a demulcent. It has also been employed 
for the cure of burns and scalds, and various cutaneous irritations, 
just as collodion is now. Both act in the same way. 

The decoction is usually made by boiling four ounces cut into 
small pieces in four pints of water, down to two. The dose is 
from four to eight ounces three times a day, and will prove a 
good demulcent in urinary affections. 

The slippery elm contains a very large quantity of pleasant 
mucilage, which renders it valuable in medicine and surgery. If 
the bark be chewed a minute or two, the mucilage is separated 
copiously. The inner bark, cut or broken into pieces and sus- 
pended in a pint of water, will soon impart its mucilage, giving 
a viscid consistence to the fluid. The Shakers prepare the inner 
bark by making it very fine, and then packing it very tight in 
papers, for sale. Thus prepared, it makes a good mucilaginous 
diet for invalids. 

The expectorant quality of this bark depends on the ready evo- 
lution of its mucilage, by chewing portions carried in the pocket 
for that purpose. 

The infusion or decoction is employed in dysentery and stran- 
gury, because of its demulcent quality. It may be taken ad 
libitum by the mouth and per anum. Made very strong, it con- 
stitutes the basis of a good poultice. 

Dr. McDowell, formerly of Virginia, has published a good paper 
on the surgical uses of the slippery elm. He made bougies, 
catheters, tents, &c. from it, which, by the development of their 
mucilage when dipped in hot water, are readily introduced. A 
very small amount of skill is requisite in order to prepare these 
utensils. The thin inner bark is very easily rolled into due form, 
which remains as long as may be desired. 

Urtica Dioica. The Stinging Nettle. — The disease called 
urticaria has been so named because it resembles the effects in- 
duced by the stinging nettle on the skin of some persons ; for all 
are not affected alike. This vegetable has been much praised for 
its good effects in certain chronic diseases of the skin, the system 
being in a cachectic state. It has long been known as a diuretic 
and anti-scorbutic, and doubtless these properties are developed 
in the use of it as named above. The decoction and extract are 
employed. The first is made by boiling an ounce of the leaves 
and stems in a quart of water, to a pint. The dose is a fourth 



UVA URSI — CRANBERRY. 803 

of a pint daily for a patient sixteen years old. The extract is 
made by gradual evaporation of the decoction, and its dose is five 
grains for a person of ten to twelve years old, twice a day. 

Patients of all ages, from four to forty, were treated with 
this remedy for psoriasis diffusa, lichen agrius, chronic lepra, 
and various scaly diseases of the skin, with good effect. One or 
two months were required to give efficacy to the medicine. Dur- 
ing this treatment the bowels were kept in a proper state, and 
the skin was the subject of warm bathing and various ablutions. — 
Association Medical Journal, November, 1854. 

Uva Ursi. Arbutus Uva tlrsi. Wliortleberry . Bearberry. — 
The leaves are generally employed, the taste of which is rather 
astringent, with some bitterness blended with a sweetish impres- 
sion. It is affirmed that they have no smell when recent, while 
the dried leaves have somewhat the odor of green hay. The 
sapid matter of the leaves depends on the presence of a gummy 
rather than a resinous matter, as its virtues are much better ex- 
tracted by water than by alcohol. The powder of the dried leaves 
is of a light-brown color. The watery extract is bitter and astrin- 
gent, having a dark-brown color, and a smell like the extract of 
dandelion or honey. The aqueous infusion of the leaves is black- 
ened by sulphate of iron, owing to the presence of tannic and 
gallic acids ; hence the incompatibility of iron preparations. It 
is because of the presence of the acids named that uva ursi has 
been employed in Russia in the process of tanning. 

The medicinal properties of uva ursi appear to reside in its 
astringency and bitterness, and hence it has been used profitably 
in affections connected with laxity of fibre, as fluor albus, menor- 
rhagia, diabetes, diarrhoea, general debility, &c. More recently 
it has been employed in calculous affections, nephritic disease, 
and dyspepsia. 

It is sometimes called a tonic diuretic, but I have not found it 
a very active diuretic, unless combined with nitre in the propor- 
tion of a drachm of the salt to a pint of infusion of the leaves. 
The dose of this mixture is a wineglassful every four hours. From 
a half-ounce to an ounce added to a pint of boiling water will 
make the infusion, which gives all the virtues of the plant. If 
needed for dyspeptics, it should be taken cold. 

The dose of the powder of the leaves is from ten to sixty grains 
three times a day, given in sweetened water or syrup. From 
two to ten grains of the extract may be taken at once. 

A notion formerly obtained that, owing to some peculiar quality 
of the blood in gout, uva ursi was far better suited to the nephritic 
form of that disease than any other medicine ; and, for aught I 
know, it may be so. 

Yaccinium Oxycoccos. Cranberry. — The scarlet American 



804 VALERIAN — VANILLA. 

cranberry is known to every lover of cranberry tarts. It is in- 
troduced here because of the very grateful drink it affords when 
water is added to the fruit stewed with sugar. In regions where 
fevers are most abundant, it is desirable to have a large variety 
of agreeable drinks to allay thirst and subdue the unpleasant 
state of the mouth and throat. If a tablespoonful or two of the 
cranberry, as ordinarily prepared with sugar, be added to a pint 
of water, we have a drink that most patients will relish, while it 
rarely does harm. 

Valerian. Valeriana Officinalis. Wild Valerian.— This 
is an article with a tuberous root and very numerous radicles, or 
very small roots shooting in all directions. The root of the wild 
sort is much more fragrant than that of the cultivated plant. It 
has a bitter, acrid taste, a very penetrating odor, which is quite 
unpleasant to most persons, though not so to all. It contains a 
volatile oil, which has been extracted and is in use ; in addition, 
it is known to contain resin, extractive, &c. The oil is of a 
greenish color, with a very penetrating odor and an aromatic 
taste, not unlike that of camphor. When the root is distilled 
with water, there passes over, in addition to the oil, a peculiar 
acid, fatty matter, called valerianic acid, having a disagreeable 
smell and somewhat the appearance of oil. This acid forms salt 
having a sweetish taste and quite soluble, and has been much 
employed in the manufacture of the valerianate of zinc. It has 
also been combined with quinine to form the valerianate of qui- 
nine, which is supposed to be a valuable medicine in cases re- 
quiring stimulating nervous tonics. 

The infusion, tincture, and ammoniated tincture have been 
employed, but the latter has been preferred. It is the medicine 
so highly praised by the author of Confessions of an Opium 
Hater, and alluded to under the article Opium. It is thus pre- 
pared : — Take of the valerian root, bruised, four ounces ; aro- 
matic spirit of ammonia, a quart. Macerate for two weeks, and 
strain. The dose is from a half-drachm to two drachms two or 
three times a day, or oftener. 

Valerian is held to be a diffusible stimulant and antispasmodic. 
The powder of the root may be given in doses of twenty to forty 
grains ; and of the volatile oil from three to five drops may be 
administered. 

Vanilla. Vanilla Aromatica. — This is a native of Peru, 
Mexico, Jamaica, and Cuba. Notwithstanding the strong odor 
of this fruit, no volatile oil can be procured from it by distillation. 
The bean, as it is generally called, is employed in this country to 
give flavor to ice creams, and is sold for this end in the form of 
what the apothecaries style vanilla extract, a liquid that is often 
of little worth. 



HELLEBORE. 805 

It has long, however, been employed as a medicinal agent, 
being regarded as an aromatic stimulant, exhilarating to the men- 
tal functions, preventing sleep, increasing muscular energy, and 
exciting the sexual feelings. It has been administered chiefly in 
asthenic fevers, rheumatism, hysteria, impotence, and melancholy. 
The dose given was from eight to twelve grains. 

A German writer commends it in adynamic fevers, hysteria, 
&c, in which he employed an infusion made by putting a drachm 
of the vanilla into three or four ounces of boiling water, digesting 
in a close vessel for half an hour, and sweetening the clear liquor. 
The whole to be taken in teaspoonful doses in the course of 
twenty-four hours. 

Veratrum Album, Niger et Virlde. White, Black, and 
Green Hellebore. — These articles are now seldom employed in 
practice, and, apart from their proximate principle, ver atria, are 
not entitled to serious attention. The most prominent and dan- 
gerous features relate to its action on the nervous system gene- 
rally, and to its violent irritation of the Schneiderian membrane. 
We speak now of the white species, a particle of which snuffed 
up the nose induces violent sneezing. On the nervous system it 
operates so as to occasion tremors, vertigo, syncope, convulsions, 
and fatal spasms. These effects have led to its use in small doses, 
in the treatment of mania, epilepsy, and various convulsive affec- 
tions, but without obvious success. Several cutaneous diseases 
are reported as having yielded to its influence. 

The following case of poisoning by white hellebore merits atten- 
tion. A man swallowed, by mistake, about half an ounce of white 
hellebore in powder, thinking it to be cream of tartar. The 
paper containing the powder was marked "poison," but this was 
not noticed at the time. Feeling sick and in pain, he sent for 
aid about four hours after the blunder. Emetics and clysters 
soon restored him. The symptoms were purging, pain at the 
stomach, burning sensation of the mouth and throat, but there 
was no vomiting till after he took the emetic. There was no gid- 
diness or other cerebral disturbance. (See London Lancet, Sep- 
tember, 1857, page 290.) We may remark, in passing, that any 
man of half ordinary sense ought to have known that he was not 
taking cream of tartar, by the taste alone. We cannot imagine 
how such a mistake could occur. 

The black variety is less energetic, and has been employed with 
success as a vermifuge, a diuretic, and emetic. The dose is from 
two to eight grains. 

The veratrum viride, or green hellebore, is an indigenous plant 
found in our swamps, and, though similar in some respects to the 
white variety, is not purgative. 

Dr. W. C. Norwood, formerly of North Carolina, has written 



806 VIENNA PASTE — WATER CURE. 

on its virtues, about which he is pretty sanguine. In the July 
number of the North American Medico-Chirurgical Review is a 
short article, by Dr. Pope, of Alabama, in which he expresses a 
very favorable opinion of the tincture of the plant in the treat- 
ment of the low form of pneumonia. He employed opium and 
brandy also, treating forty cases successfully. The dose of the 
tincture was six drops. 

Touching the proximate principle, veratria, we refer to the 
article Colchicum Autumnale. 

Vienna Paste. — This caustic is now so often mentioned in 
the journals as to create a necessity for introducing it here. It 
is composed of five parts of pure lime and six of pure potash, 
made into a paste with alcohol. (See London Lancet, December 
2, 1843.) Dr. Mitchell (of Ireland) is very partial to this arti- 
cle in the treatment of ulcers of the os and cervix uteri. Gen- 
drin prefers to have the lime and potash in fine powder, in a tight 
bottle ready for use, to be made into paste as it may be wanted. 
He applies the paste on a small bit of adhesive plaster. Dr. M. 
prefers to attach the paste to the end of a glass rod to be passed 
through the speculum, so as to lodge the paste on the ulcerated 
spots. 

Water Cure. — It is not our intention to waste pen and ink 
on the mania that has recently marked hydropathy, or the water 
cure. We have taught our pupils that in centuries gone by fevers 
of all grades were treated almost exclusively by the internal and 
external use of cold water, and that so soon as it became the one 
idea of medical men, it fell into disuse. Currie, in more recent 
times, wrote a pretty large volume on the curative powers of cold 
water ; and every wise physician knows the worth of the remedy 
as one of the many means within his reach. Under the article 
Aqua we have set forth the medicinal powers of water in no 
dubious point of light. 

Any one who will refer to the London Lancet (New York edi- 
tion) for February, 1846, will see that rheumatisms, colds, &c. 
&c. were treated in Yorkshire, England, by wrapping patients in 
sheets wrung out of cold water, after which they were put to bed, 
to remain there for hours with their cool investiture, so long ago 
as 1738. 

We have not now for the first time to apprise our readers that 
sudden and most unexpected deaths have occurred under the 
actual operation of the water cure, even when assurances of re- 
covery had been repeatedly made. The facts teach very plainly 
that the remedy is not a panacea; and they as clearly confirm 
the old saying, "what is one man's meat is another's poison." 
No man who regards his own life, or that of his relative or friend, 
as it should be regarded, should ever consent to such an expe- 



WHEY — PRICKLY ASH. 807 

dient until the soundest medical opinions in its favor for the given 
case could be obtained. 

Whey. — We have spoken of alum whey, and now introduce a 
very useful article, viz., wine whey. And we notice it here be- 
cause it is so frequently prepared in an improper manner. To 
make good wine whey, a new white earthen vessel should be 
selected, and a pint of new milk should be boiled in it over lively 
coals, the vessel being covered tight. While in the act of ebulli- 
tion, remove it from the fire and pour in the wine, (a half-gill or 
more,) and set the vessel aside. When nearly cool, pour the whole 
on a fine gauze to separate the whey from the curd. Let the 
clear whey be made palatable by nutmeg and sugar, as may be 
most agreeable. 

Whisky. — We name this product of the still as a good 
external medicine, alone or combined. Heated over red-hot 
coals and rubbed smartly on the skin, or applied by flannels re- 
peatedly soaked in it, the physician will find it a good embroca- 
tion. In some places burns and scalds are treated with cloths 
soaked in whisky, which are said to give speedy relief. 

In the western country it used to be a practice of travelers on 
horseback, in very cold weather, to pour strong whisky into their 
boots just before drawing them on. Whether the custom was 
really a wise one I am not prepared to say, but I presume that 
good results followed it. Certainly the liquor was safer there 
than in the stomach. 

Whisky holding cayenne or black pepper, or camphor in solu- 
tion, furnishes a very good external application to painful parts, 
and is therefore much employed by old rheumatics. Let it be 
restricted to the external use and it will rarely do harm. 

Witch Hazel. (See Hamamelis Virginiana.) 

Xanthoxylum Fraxineum. Prickly Ash. The BarJc. — 
This plant is a native of North America, and may be found in 
most sections of our country, growing in woods and thickets, and 
flowering in April and May, before the leaves appear. It is 
quite a small shrub, with alternate branches, and armed with 
short and very strong thorns or prickles. The flowers are small 
and greenish, and have rather an aromatic odor. The entire 
plant would seem to be possessed of active qualities ; the leaves 
and fruit abound in a fragrant volatile oil, and the bark is acrid, 
pungent, and aromatic. The latter yields its properties to boil- 
ing water and to alcohol, and hence the infusion or tincture. 
Chemical research has detected a peculiar crystalline principle 
or substance called xanthoxylin, which is not unlike piperine. 

This article is an acrid stimulant, and has been much em- 
ployed as a domestic remedy for chronic rheumatism, flatulence, 



808 USES OF YEAST. 

and colic. Externally it has also been employed in the treatment 
of indolent ulcers. 

The dose of the powdered bark is from ten to twenty grains. 
The decoction is made by boiling an ounce of the bruised bark 
in three pints of water, down to a quart, a pint of which may be 
taken in the course of twenty-four hours. To make the infusion, 
digest two ounces in a gallon of boiling water for ten hours ; of 
the clear liquor, take a pint in twenty-four hours. 

I knew a respectable drunkard who was confined to his cham- 
ber and watched to prevent the use of ardent spirits, who found 
a hidden quart bottle of saturated tincture of the leaves and 
bark of the prickly ash, so exceedingly hot and irritating that 
no sober person could more than taste it. This man contrived to 
swallow the whole in the course of two or three days, to gratify 
his love of strong drink. 

The strong tincture would be a safe and salutary rubefacient, 
and in small doses a good antispasmodic. Half a teaspoonful 
might serve this purpose. 

Yeast. Cerevisice Fermentum. — The brewer's yeast is pro- 
duced from the fermentation of malt, and consists of a frothy 
scum and a sediment. It is called barm, in Great Britain, more 
frequently than yeast. It is quite a complex substance, contain- 
ing some alcohol and water, carbonic, acetic, and malic acids, 
potash, lime, and a saccharine mucilaginous extract. Its most 
important ingredient is a mass of microscopic globules, regarded 
as organized cells and endowed with life. A prominent quality 
of yeast is that when in contact with saccharine solutions at 75° 
Fahrenheit, it induces fermentation, and a conversion of the 
sugar into carbonic acid and alcohol. As this property depends 
on the presence of the cell structure, the drying of the yeast 
very much impairs it, and a heat of two hundred and twelve 
destroys it wholly. 

It was supposed that an agent thus endowed with vitality, and 
competent to produce such changes as those referred to, might be 
useful as a medicinal appliance, and hence it has been frequently 
resorted to. 

It was employed in the city of Philadelphia, in the time of my 
pupilage, by the late Dr. Parrish, in the treatment of typhus 
fever, which proved so fatal in the suburbs. By reference to the 
Philadelphia Medical Museum of 1810, it will be seen that the 
remedy was employed by other physicians in the same disease, 
with success. It was given in tablespoon doses every half hour 
as a stimulant and tonic. Dr. Christison speaks of it as given 
formerly by the mouth and by injection, in typhoid fever , by 
which probably he meant the same as typhus. 

Having witnessed the practice of Dr. Parrish, and been fre- 



USES OF YEAST. 809 

quently in the rooms of the patients, I feel somewhat qualified 
to say that the practice was a good one, the effects of the remedy 
being speedily apparent. And more than this, I have employed 
the yeast myself in like circumstances, and therefore am pre- 
pared to commend its administration. 

Dr. Stoker, a physician of Great Britain, who has had very 
large experience in the management of typhoid fevers, says that 
yeast may be given whenever it can be retained by the stomach, 
even when the existence of inflammatory complications prevents 
the use of other stimulants; and that it is generally easily taken 
alone, or with any other medicine, or in any vehicle that may be 
deemed advisable. In the worst forms of typhus, when it is 
most needed, he states that it is rarely rejected, but, on the con- 
trary, is much relished ; and that it is moderately laxative, often 
superseding the use of purgatives. If it prove not sufficiently 
aperient, he gives a little tincture of jalap in it ; and if the 
bowels are too much relaxed, a few drops of tincture of opium 
are added to each dose. It appears to Dr. Stoker to correct the 
morbid contents of the alimentary canal, and the consequent 
symptoms of putrescence ; petechia and black tongue being more 
effectually removed by it than by any other means. He has, 
therefore, substituted it for bark and wine when they could not 
be employed on account of inflammatory symptoms, and has 
conjoined it with them when there was no such counter-indication. 
He prescribes the yeast in doses of two tablespoonfuls every 
third hour, with an equal quantity of camphor mixture. If ad- 
ministered in enemata, three times the above dose may be em- 
ployed. Dr. Stoker, whose experience of this treatment has 
been long and most extensive, observes that instead of increasing 
the tendency to tympanitic distension, by promoting fermenta- 
tion, as may be objected, it actually prevents the accession of 
this symptom ; and that, in the most obstinate instances of 
typhoid tympany, he has found enemata of yeast and assafoetida 
the most efficacious remedies. 

The following preparation has been very useful in typhus 
fever of Ireland, as we learn from a report by Dr. Lamprey. 
When the discharges from the bowels were very fetid, and the 
petechise became quite livid, he gave the following mixture : — 

R. — Cereviss. ferment. %x ; 
Camphorae, gss ; 
Spt. nit. dulc. ^ss. 
Mix. Give an ounce every hour, or every two or three hours, according to 
circumstances. 

It stays the septic or putrefactive process, and is a decided 
stimulant. It not only corrects the fetor of the discharges, but 
lessens their frequency. The mixture soon becomes so agreeable 

52 



810 PREPARATIONS OF ZINC. 

to the palate that it is anxiously desired, and there is danger of 
the patient using it too freely. (See Braithwaite, part xx.) 

Not a few foreign physicians report decidedly good results 
from the use of yeast in malignant scarlet fever. After am- 
monia, the mineral acids, chlorate of potash, &c. have failed, as 
well as the free use of nitrate of silver, one or two tablespoonfuls of 
fresh yeast frequently given, say every half hour or every two 
hours, according to the malignancy of the symptoms, have been 
speedily efficacious as an antisepect and stimulant — Bond. Med. 
Gaz., Jan. 10, 1851. 

The common furunculus, or boil, which frequently baffles ordi- 
nary means, has yielded quickly to a tablespoonful of good yeast 
in a little water, taken five or six times a day. The remedy is 
safe, at all events; and if we do not exactly know its modus 
curandi, what of that ? — Braithwaite, part xxvi. page 294. 

Its antiseptic and disinfectant qualities render it suitable, by 
way of injection, to correct the foul discharges that often attend 
dysentery, and to stimulate the system gently in the low form of 
that disease. 

But yeast has also been advantageously employed as an anti- 
emetic for the relief of a decidedly irritable stomach. From a 
tea to a tablespoonful may be given every ten or fifteen minutes. 

The yeast poultice is often usefully applied to foul, fetid, or 
malignant ulcers. Flour and good brewers' yeast, or Indian 
meal and the same article, may be blended together, taking care 
to have as much yeast as the flour or meal will absorb. Apply 
immediately, and repeat three or four times a day. I regard 
this a pleasant and salutary expedient. 

Zincum. Zinc. Spelter. — The only medicinal application of 
the metal is in the construction of galvanic batteries for medi- 
cal use, and it is not necessary to speak on that point here. We 
may simply remark that suituble machines are manufactured and 
for sale in all our large cities, and they can be safely transported 
to any point of the country at a small cost. 

The preparations recognized in practical medicine are the 
oxides, carbonate, acetate, sulphate, valerianate, chloride, iodide, 
and cyanide, to each of which we intend to devote a few remarks. 

The oxides employed are the pure oxide, called flowers of 
zinc, pompholix, nihil album, philosophical wool, &c. &c. ; and 
the impure oxide, called tutty, or the gray oxide. 

The pure oxide, or flowers of zinc, are prepared by exposing 
metallic zinc to a high temperature, by which they are oxidated 
rapidly. The same oxide is also made by precipitation with 
liquid ammonia added to a solution of the sulphate of zinc. The 
salt is decomposed, its oxide thrown down, and sulphate of am- 
monia held in solution. 



PREPARATIONS OF ZINC. 811 

The pure oxide is colorless, insipid, and insoluble in water, 
though readily soluble in most of the acids. Its adult dose is 
from two to ten grains, joined to some of the bitter tonics. It 
is held to be a tonic and antispasmodic, and thence employed in 
the treatment of chorea, epilepsy, &c. 

The colliquative sweating in phthisis has been happily arrested, 
according to Dr. T. Thompson, by the use of pills made of oxide 
of zinc and ext. bellad. aa four grains, divided into two pills, 
taken at bedtime. This medicine has an advantage over other 
means, in that it does not give rise to those severe attacks of 
diarrhoea which supervene on the arrest of profuse perspira- 
tion. — Lond. Lancet, April 1, 1854. 

The foregoing is confirmed by the following testimony in this 
country, as follows : — 

Dr. S. L. Abbot, of Boston, reports in the Boston Medical and 
Surgical Journal the result of the use of the oxide of zinc, in 
combination with the extract of conium or hyoscyamus, in the 
treatment of the night-sweats of phthisis. In all these cases, 
one only excepted, the sweats were readily brought under the 
control of the remedy presented, being either completely checked 
or greatly diminished. His usual dose was four grains of the 
oxide to three of the extract, given in two pills at bedtime. In 
a subsequent number of the same journal, Dr. J. B. S. Jackson, 
of Boston, relates his confirmatory experience of the benefits to 
be derived from the use of the oxide alone. It was administered 
freely whenever there was perspiration enough to require treat- 
ment, and without any regard to the stage of the disease. Seven 
grains were given in substance, generally at bedtime, but also 
during the day, at intervals of three or four hours, if necessary. 
Sometimes ten grains were administered without any unpleasant 
effects being complained of. Dr. Jackson also states that excessive 
perspiration may probably be successfully treated by the zinc when 
it occurs in other diseases. He himself employed it, with bene- 
ficial results, in two cases, one being that of a person who suffered 
from copious night-sweats while convalescing from intermittent 
fever, the other that of a strong, healthy man, under an attack 
of acute rheumatism, who had the profuse perspiration that so 
often accompanies this disease. He has also seen perspiration 
checked under its use in a case of cancer of the womb. 

Sometimes the oxide is rubbed with lard, to form an ointment 
to be applied to ulcerated surfaces, and the fine dust of the oxide 
is useful to excoriated parts. The impure oxide is also employed 
in making ointments. 

Carbonate of zinc, or calamine, or prepared calamine, is a light, 
pink-colored, earthy-looking substance, chiefly employed in the 
formation of the ceratum epuloticum, or Turner's cerate, or 



812 USES OF ZINC SALTS. 

healing salve. A drachm of the fine powder intimately rubbed 
with an ounce of simple cerate or lard will give a very good 
article of this kind. 

The fine powder of calamine has also been used to prevent the 
pitting and scarring of small-pox ; but it is not so good an ap- 
plication as the tincture of iodine or nitrate of silver. 

Sulphate of zinc is the best known and most important of all 
the zinc compounds. It is sometimes called white copperas, 
white vitriol, &c. The action of diluted sulphuric acid on zinc 
filings or cuttings will give rise to this salt. On evaporating the 
solution thus made, crystals of the sulphate are deposited. For 
commercial purposes, it is manufactured largely from the sul- 
phuret of zinc by roasting and exposure to the air. The sulphur 
is changed to sulphuric acid, the zinc oxidated by absorbing 
atmospherical oxygen, and the two uniting give birth to the salt. 

Pure sulphate of zinc is white, astringent, and has a nauseous 
and metallic taste. It dissolves in less than its weight of boil- 
ing water, and in rather less than thrice its weight of water at 
sixty degrees Fahrenheit. It is not decomposed by anything 
below a red heat, which drives off the acid and leaves the oxide 
free. 

Sulphate of zinc is employed internally as a tonic and emetic, 
externally as an astringent. In cases of defective tone of the 
stomach and bowels, it is exhibited advantageously in quarter- 
grain doses, twice or thrice a day, with an eighth of a grain of 
sulphate of morphia. It is believed by some physicians to be 
preferable to all other mineral tonics, in all diseases of debility 
associated with subacute inflammation, because less apt to excite 
arterial action, thirst, or other febrile symptoms. 

Braithwaite'' 's Retrospect, part vi., presents some useful hints 
on the happy agency of the sulphate for the relief of flatulent 
colic dependent on enlargement and debility of the colon. 

Favorable mention is made in the London Lancet for 1843, 
of the use of sulphate of zinc in doses of from two to ten grains, 
in the treatment of chorea. The dose named was given three 
times a day for several weeks. 

In subsequent numbers of the Lancet, and in other journals, we 
find abundant proofs of the salutary influence of this medicine in 
the same disease. Drs. Addison and Barlow are quite positive 
as to the happy agency of the sulphate. It is believed to exert 
very much the same kind of influence on the nervous matter that 
iron produces in the blood. A very good account may be seen 
in Braithwaite, part xxiii., page 75, and in the London Lancet 
for January 11, 1850. 

Pertussis, or hooping-cough, has often been relieved by an 
eighth of a grain of the sulphate dissolved in a teaspoonful of 



WHITE VITRIOL. 813 

a strong solution of sulphate of quinine and given two or three 
times a day. The solution of sulphate of quinine for this end 
should consist of ten grains to an ounce of water. Mosely's 
celebrated remedy for hooping-cough consisted chiefly of the 
sulphate of zinc. 

Gargles of the sulphate have been frequently recommended 
for ulcerated sore throat, or for simple inflammation, or relaxa- 
tion of the soft parts, as the fauces, uvula, &c. But its very 
unpleasant taste renders it quite objectionable, unless some addi- 
tion be made to counteract it. In place of an aqueous solution 
in simple water or in rose-water, let the following be tried : — 

R. — Sulph. zinc, "^i; 
Aq. rosar. jfyi ; 
Syr. scill. Jfi. 
Mix. Let this be shaken well, and employed as a gargle several times a day. 

Sulphate of zinc is called a 'prompt emetic, because of the 
rapidity of its action. On this account it is employed to dis- 
lodge opium and other poisons from the stomach. It rouses, in 
a remarkable manner, the dormant energies of the stomach, and 
is therefore a valuable medicine. The mode of using it, as a 
prompt emetic, is to dissolve a drachm in a teacupful of warm 
water and to give one-fourth, and repeat in ten minutes if ne- 
cessary. 

A solution of five grains in five ounces of rose-water makes a 
good wash for inflamed eyes, after proper depletion by the lancet, 
or by cups and leeches. A like solution is sometimes applied to 
arrest discharges behind the ears of infants ; but care should be 
taken to purge freely two or three times a week at the same 
time. 

The practice of using strong solutions of sulphate of zinc in 
gonorrhoea is often very injurious, by inducing stricture of the 
urethra and swelled testicle. They should never be employed 
until after inflammatory action has been subdued, and even weak 
solutions are to be preferred. 

The sulphate has been reported as a good remedy for polypi. 
Dr. Turner relates, in the London Medical Gazette for July, 
1836, the following case : — A young lady consulted him in March 
about a polypus of the gelatinous kind, with a broad foot-stalk, 
extending from the middle chamber of the nose far back to the 
posterior nares. She was directed to use the following lotion : — 

R. — Sulph. zinc, ^ij ; 

Aquse, ^vij. 
Mix. 

The quantity of the sulphate was gradually increased, and 
the solution employed by soaking lint in it and passing it down 



814 ACETATE OF ZINC. 

to the 'polypus, morning and evening, and to remain all day. 
The lotion was also applied by means of a syringe, occasionally. 
In two months the polypus was completely cured. Probably 
the remedy acted as an astringent. 

Mr. Pretty notices the plan of Deschamps for the abortive 
treatment of coryza, and then adds what he thinks a more easy • 
method. He directs a solution of sulphate of zinc, containing 
three grains to an ounce of water, to be injected into the nose. 
An ounce syringe is employed, and part is thrown up each nos- 
tril, the patient leaning over a basin. One injection often 
suffices, and seldom is it needful to inject more than three times. 
A coryza of several days' standing has been arrested in ten 
minutes, in this manner. (See London Medical Gazette, July, 
1849.) 

Sulphate of zinc has been mistaken for sulphate of magnesia. 
The difference of taste should prevent an error of this kind, as 
the bitterness of the magnesian salt is a sufficient characteristic. 
The chemical differences require more care than practitioners 
can give to a matter of this kind. 

The most obvious incompatible of sulphate of zinc is the sugar 
of lead, and it is so, because the mixture is so frequently pre- 
scribed. Double decomposition ensues, acetate of zinc being 
held in solution and an almost insoluble sulphate of lead being 
thrown down. The mixture is far less active than either of its 
constituents, per se. 

Orfila speaks of a female who accidentally drank a solution of 
two ounces of sulphate of zinc at once. The dose caused an 
excessively astringent taste, contraction of the throat, burning 
in the stomach, cold extremities, pale countenance, irregular 
pulse. Vomiting came on and continued for some time, after 
which emollients and bland drinks allayed the existing irritation. 
Metzger relates the case of a woman who died in consequence 
of eating part of a cake that had been baked for the destruction 
of an old man, and highly charged with sulphate of zinc. Both 
were seized with vomiting, but the man got well. 

The morbid appearances detected after death were slight effu- 
sion of blood on the lining membrane of the stomach, and green 
spots in the course of the bowels. The other parts were natural. 

The treatment advised, when the salt has been swallowed, is 
to promote vomiting so as to throw off all the poisonous matter. 
Give emollient drinks, and particularly milk, which seems pos- 
sessed of a decomposing power over the sulphate. If there be 
inflammation, bleeding, both local and general, should be em- 
ployed ; and, if needful, anodynes to allay irritation. 

Acetate of zinc is sometimes employed in practice. It is 
always formed when sulphate of zinc and acetate of lead are 



VALERIANATE OF ZINC. 815 

mixed in water. The clear supernatant fluid being evaporated, 
yields the acetate in the form of white, silky-looking crystals. 
These are quite soluble in water, and effloresce a little in the 
dry atmosphere. From two to five grains in an ounce of water 
make a good solution. 

Valerianate of zinc has been much employed in Europe in 
the treatment of neuralgic affections, and we doubt not that it is 
a good preparation, although we have never used it. As long 
ago as 1843, M. Cerulli, an Italian physician, administered it in 
a good many cases. In three patients affected with supra-orbital 
and infra-orbital neuralgia, a cure was effected by doses of a 
grain and a half daily, divided into two pills, to be taken at the 
moment when the paroxysm came on. In one, the cure was 
complete in thirty days, in another, in forty, and in the third, in 
fifty days. (See Graz. Mecl de Paris, January, 1844.) 

Neligan regards the valerianate of zinc as a tonic antispas- 
modic of much power, and suited to neuralgias attended with loss 
of tone in the system at large. In facial neuralgia and in ver- 
tigo it has been eminently useful, but, most of all, in hysterical 
neuralgias. According to Neligan, the medicine may be exhi- 
bited not only in pill, as already stated, but in a solution of 
orange-flower water, or in distilled water flavored with syrup of 
orange-flowers?. It should be recollected that the crystals of the 
valerianate do not easily dissolve in cold water, and hence it is 
best to rub them first in a mortar with a very little water. 

All acids, the solid carbonates, most metallic salts, and as- 
tringent vegetable infusions and decoctions are incompatible. 

To make this salt, take two pounds of bruised valerian root, 
eight pounds of water, three ounces and a drachm of sulphuric 
acid. Macerate for two days, and distil until the liquid no 
longer reddens bibulous paper. Let the product be exposed one 
month to the air, after which put it in a matrass with a half- 
ounce of recently-precipitated and perfectly pure hydrate of zinc, 
and digest for ten hours in a sand-bath at 176°, stirring occa- 
sionally. Filter the warm liquor, evaporate to three-fourths of 
its volume, pour into porcelain capsules, and expose to the heat 
of a stove until crystals are formed, which are to be dried with 
filtering paper. 

An elegant article of this salt is manufactured by Messrs. 
Rosengarten and Sons, of Philadelphia, and on sale at their 
establishment. When pure, it is in light, pearly, crystalline 
scales of brilliant whiteness, with a feeble valerianic odor. It is 
soluble in fifty parts of cold, in forty of hot water, and in six- 
teen of alcohol. 

Lactate of zinc is a very white salt recently introduced. It 
is manufactured by the house named above, and will no doubt 



816 CHLORIDE OF ZINC. 

prove a good tonic antispasmodic. It has not been sufficiently 
tested to enable us to speak definitely of its value. 

Cyanide or cyanuret of zinc is a compouud of zinc and cya- 
nogen. It is prepared by the double decomposition of sulphate 
of zinc and hydrocyanate of potash, which gives a triple hydro- 
cyanate of zinc. This is to be calcined at a dull-red heat, which 
converts it into cyanide of zinc. 

This preparation is affirmed to be an excellent vermifuge, in 
die dose of from an eighth to a quarter of a grain. A writer 
in HufelanoVs Journal for 1823 says he has often combined it 
with jalap as a vermifuge, with happy result, in proportion of 
one grain to five or six grains of jalap. In nervous affections 
and cramps of the stomach he employed it with calcined magne- 
sia, and regarded the mixture as well suited to many cases of 
dyspepsia. 

A writer in the Provincial Medical Journal speaks highly of 
an ointment of cyanide of zinc for ulcers of the cornea. It is 
made with one grain of cyanide and twenty-five of lard, and is 
applied with a fine hair pencil. 

Chloride of Zinc. Muriate^ of Zinc. — Metallic zinc dissolves 
readily in diluted hydrochloric acid, evolving hydrogen gas and 
forming the chloride, which is obtained by evaporating the fluid. 
A purer kind is obtained by dissolving a hundred grains of granu- 
lated zinc in a sufficient quantity of muriatic acid, to which five 
parts of nitric acid have been previously added, and then evapo- 
rating to dryness. The residuum is redissolved in -water, five 
parts of powdered chalk being added; and, after being in contact 
for twenty-four hours in a cold place, the fluid is to be filtered 
and again evaporated to dryness. 

Chloride of zinc thus procured is in white, friable masses. It 
has no smell, but a sharp, saline, styptic, metallic taste. It dis- 
solves readily in water, alcohol, and ether, and its solutions have 
an acrid reaction. It is the most deliquescent salt known, and 
must be kept in the best-stoppered vessels. It is an efficient 
escharotic. 

The chloride has been called a tonic and antispasmodic, but is 
rarely used internally. M. Gandriot called it a specific for 
gonorrhoea. He employed a solution for men and a supposi- 
tory for women. The solution consisted of from twenty-four to 
sixty drops of the liquid chloride in four ounces of distilled 
water. These were mixed and filtered through paper, and the 
clean liquor injected into the urethra two or three times a day. 
The suppository was made of five drops of the liquid chloride of 
zinc and a half-grain of sulphate of morphia, mixed with six 
parts of mucilage of gum Arabic and three of sugar, so as to 
make a paste. Two or three injections for as many days gene- 



IODIDE OF ZINC. 817 

rally cured males; a suppository passed up every day for a week, 
sufficed in women. 

The celebrated surgeon Guthrie employed the chloride with 
success in necrosis, to soften the bone and enable the operator to 
get at the sequestrum. 

One of the simplest uses of the chloride is in toothache. Dr. 
Stanelli applied it by means of a fine pencil to the cavity of a 
tooth, and promptly arrested the pain. It is affirmed to be 
generally successful. — London Medical Gazette, 1844. 

Phagedenic ulcers of the septum nasi have been promptly 
relieved by the chloride. A grain and a half dissolved in an 
ounce of pure water makes the solution, which is to be painted 
on the diseased spots three times a day with a fine hair pencil. 
At the end of a fortnight the disease was arrested, and in four 
or five weeks quite cured. (See Edinburgh Monthly Journal of 
Medical Science for 1843.) 

Dr. Fell, an American, it is said, has caused a wide-spread 
sensation by his treatment of cancer, fungus nematodes, &c, 
with chloride of zinc, in the British metropolis. The chloride is 
applied in form of weak solution, and by its escharotic power 
promptly destroys cancerous tumors without inducing much pain 
at the time, although, if reports be true, the pain is sometimes 
dreadfully severe a few hours after. An. eminent artist of our 
own country has been under this treatment, and there was enter- 
tained a prospect of recovery. We understand that the com- 
mon blood-root (sanguinaria Canadensis) enters into Dr. Fell's 
formula. 

After the above was penned, the interesting article of Prof. 
Gibson, on the case of the sculptor Crawford, was laid before 
us, and it has led us to doubt the correctness of previous rumors 
touching the probability of his recovery. We are inclined to 
regard Dr. Fell's practice as sheer quackery. 

Still later, our attention has been called to a review of Dr. 
Fell's book on Cancer in the London Lancet for September, 
1857, and we feel more confirmed in the sentiment expressed , 
above, and are not a little mortified at the developments made 
by the reviewer. They certainly do not flatter our national pride. 

The Montreal Medical Journal for 1846 speaks well of the 
chloride of zinc as an excellent article for the preservation of 
subjects for dissection. 

Iodide of zinc is readily made by heating a mixture of iodine 
and zinc filings in a close vessel. The compound is white, dis- 
solves readily in water, and is changed to iodate and hydriodate 
of zinc. The iodide of zinc has been recommended by Dr. Ure, 
for reducing glandular swellings, in the form of ointment. This 
is made by rubbing a drachm of the iodide with an ounce of 



818 ZINC POISONOUS. 

hog's lard. A drachm of the ointment is to be rubbed into the' 
swelling two or three times a day. A grain, dissolved in an 
ounce of water, constituted an injection sometimes employed in 
scrofulous gonorrhoea. 

Dr. Barlow has treated hysterical chorea with syrup of the 
iodide of zinc, with full success. The patient was sixteen years 
old, and had been ill for a considerable time. As hysteria com- 
plicated the case, aloes and tincture of valerian were also given. 

The treatment was continued nearly twelve weeks, at the end 
of which every vestige of disease had left her. Half-drachm 
doses of the syrup were given in mint-water three times a day, 
and the bowels were kept in a soluble state by the use of calomel 
and colocynth, and also decoction of aloes. — London Lancet, 
Dec. 31, 1853. 

We close our remarks on this subject with a few considera- 
tions on the injurious tendencies of metallic zinc. It was for- 
merly believed that zinc would be a perfectly safe substitute for 
lead in domestic economy, and hence a substitution of zinc for 
leaden pans in dairies. An individual who made one of the first 
trials of the substitute, found that although the zinc pans raised 
more cream than the leaden vessels did, the milk was so seriously 
affected that he threw it to the pigs. Nor was it very difficult 
to perceive that if the milk acquired any injurious property from 
the zinc, the pigs could not but feel the effects more or less, and 
that ultimately man must suffer. And who can doubt that, in 
this country at least, where every one aims at making the most 
money he can, instead of the pigs getting the zincky milk, it 
would be scattered among those who are in the habit of pur- 
chasing that article for family use? 

There are some experiments on record, in the 17th volume 
Annales oV Hygiene, leading to the inference that roofs of zinc 
may contaminate rain-water, and thus render deleterious the 
water of cisterns, which, in many places, is used largely. It is 
stated, on the other hand, by a writer in Silimans Journal, vol. 
xxxi., that no traces of zinc could be found in water collected 
from a zinc roof. The subject is one of much importance; for 
it should be remembered that the oxide of zinc, said by some to 
be formed in this way, is poisonous in large portions. 

Zinc is no doubt improper for utensils designed for processes 
of cookery. It is easily oxidated by exposure to the air, and, in 
contact with vinegar or acescent matter, the acetate of zinc will 
be formed. Vauquelin and Degeaux assert that an oxide is pro- 
duced if water be allowed to remain in a zinc vessel for some 
weeks, owing to the decomposition of some of that fluid. The 
same chemists have given it as their decided opinion that it is 
not safe to employ zinc for culinary purposes. 



GINGER ROOT. 819 

Zingiber. Ginger. The root. — It may seem strange, and 
yet it is true, that the natural history of ginger is involved in 
obscurity. It is. questioned whether the black and white ginger 
are the products of the same or different plants, whether or no 
they result from difference of manipulation. Hence it is affirmed 
that the one sort comes from the East, the other from the West 
Indies. The prevailing opinion is that the white Jamaica ginger 
is the best. 

It is very certain that the plant can be propagated by cuttings 
of the root-stalk. The green ginger, as imported into this coun- 
try and sold under that name by the confectioners, could be 
cultivated beyond doubt. Some of the roots, as we get them, 
are evidently sprouting, and require only a good soil to insure 
the right development. 

All the imported ginger is remarkable for a heating, pungent, 
aromatic property, that is persistent even after the article has 
been long dried and pulverized. All the qualities are readily 
imparted to water and to spirit. The watery preparation is the 
basis of the syrup which is so extensively employed. The 
essences of ginger are only so many concentrated preparations 
by the aid of pure spirit or fourth-proof brandy. 

A very fair tincture can be made by macerating, for a month, 
(the longer the better,) four ounces of bruised ginger root in a 
quart of rectified spirit. The dose may be from ten to sixty 
drops, taken on loaf sugar ; and it will prove to be a good car- 
minative, relieving occasional pains of the stomach very promptly. 
The essence of ginger is only a variety of well-prepared and highly 
concentrated tincture. It was a very popular medicine during 
the prevalence of Asiatic cholera in 1849, in Philadelphia, and I 
have no doubt was of great service by allaying fears and reliev- 
ing intestinal disquiet. For these reasons, if for no others, it 
may be regarded in the light of a good family medicine.* 

The syrwp of ginger is made sometimes from a strong infusion 
and sometimes from a tincture. Either will answer sufficiently 
well. I prefer the strong infusion, made by boiling four ounces 
of ginger root in a quart of water for the space of four hours, 
adding water as evaporation goes on. To the filtered liquor add 
enough refined sugar to make a rich syrup by the help of heat. 
This syrup will be unchanged by time if kept in a cool cellar. 
The addition of one or two tablespoonfuls to a tumbler of cold 
water, well stirred, makes a pleasant draught, and one that may 
be repeated, in hot weather, advantageously. , The syrup is also 
an excellent vehicle for the administration of medicines whose 
qualities require concealment. 

* The finest article of the kind I have used, is the preparation of Mr. Frede- 
rick Brown, of this city. 



820 PREPARATIONS OF GINGER. 

A very pleasant drink, called ginger heer, is readily made as 
follows : — Take thirteen pounds of sugar, twelve good lemons, or 
an equivalent of lime-juice, eight ounces of bruised race ginger, the 
whites of six eggs, well beaten, and ten gallons of water. Mix 
these, and boil for at least twenty minutes, skimming carefully 
before the boiling commences. Add an ounce of isinglass and a 
spoonful of balm, and put the whole in a cask. In ten days it 
will be ready for bottling. 

Externally applied, the decoction and tincture of ginger will 
act as a rubefacient. To accomplish this, a flannel soaked tho- 
roughly in the heated liquid should be applied and bound down 
by a good bandage. In persons whose skins are very delicate 
there will not only be decided redness induced, but sometimes 
actual vesication. 

We have alluded to the aromatic, warming, carminative opera- 
tion of the medicine, taken internally, and can cordially recom- 
mend it in all these relations. The fine powder is sometimes an 
available err7iine, while the solid root is a good substitute for 
tobacco, being anything but offensive to the person chewing it, 
or to others. 

We may add that ginger is an article of great antiquity, and 
was always prized as we value it now. In short, there is no sub- 
stance, vegetable or mineral, that can be an adequate substitute 
for it. 

The powdered or ground ginger of the shops is frequently 
adulterated with Indian meal, turmeric, and fine wood saw-dust. 
For this reason the root should be preferred. 



THE END. 



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